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

It’s an emergency, so you do your best under the circumstances and deal with complications as they come.

In the case of anesthesia, they’re worried about the possibility of the drug making the patient vomit, or worse, vomit just a bit and then inhale it back into the lungs. If you plan the surgery, you can plan on the person having an empty stomach, but in the emergency room you assume it’s full, hope for the best, and be prepared for the worst.

One thing they can do is run a tube down the airway to keep it open and free from contents from the stomach. There’s an entire procedure for doing this quickly before the surgical procedure begins.

But it’s still emergency medicine: hope for the best, prepare for the worst, prioritize in order of criticality.