How do trauma surgeons deal with the fact that the patients they operate on probably haven’t fasted the night before given that trauma patients don’t know in advance they’ll be having surgery?

Question

I know that with elective surgeries, patients have to fast the night before to prevent vomiting when they go under anesthetic, but I was wondering how this concern is navigated in trauma or emergency surgeries in which patients definitely didn’t fast the night before? Do they just try to deal with the vomit or is there a special procedure to prevent vomiting from occurring?

In: 1727

Answer 1

ED nurse here.

Trauma surgery implies a patient that has been injured severely enough that requires immediate surgery. Measure are of course out in place to reduce risk for aspiration, but understand that trauma surgeries are time critical, so you need to prioritize the surgery. The benefits outweigh the risk (live patient with vomit in your lungs>dead patient with no vomit in your lungs). This is not to say that aspiration risk isn’t important, rather that it doesn’t matter if you are 1 hour ago. You will likely die without the surgery.

Also, when an advanced airway is placed, ie. ET tube, your airway is protected to see degree. Anything above the cuff can and should be suctioned.