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

There are some of the anesthesia drugs, like propofol, that have antiemetic effect but really trauma surgery is all about risk/benefit. If immediate surgery is required to save life or limb, then the risk of aspiration is worth taking. Also many emergency procedures now, like say appendectomy, can be done using a spinal and so the risk of aspiration goes way down without intubation. Also, in general, the science has changed on preoperative fasting, and unless you are having major bowel surgery, you can down have clear fluids up to a few hours before a lot of procedures. It has been recognized that the negative impacts of fasting on blood sugar (especially for diabetics), body temp regulation, and post op recovery is often greater than the risk of aspiration. Source – am RN.