If you were in a car crash and had been eating all day, how is that different from a routine surgery where you weren’t allowed to eat for a certain amount of time before surgery?
Edit: based on some answers, perhaps I should clarify obviously I understand they have to perform surgery in an emergency. My question is more what do they do in an emergency when you haven’t fasted.
Thanks to those with real answers, I never knew about the special tube that could be used. That’s pretty cool.
I’m having surgery tomorrow and can’t eat so was just wondering how they handle food in the stomach during an emergency surgery situation.
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Anesthesia can cause people to throw up, and choking is a bad thing. In an emergency the hospital doesn’t have the luxury of waiting hours to be sure your stomach is empty, as that delay could lead to disaster. Not eating beforehand is a small price to pay to be sure a patient won’t choke on their vomit.
You don’t eat before a scheduled surgery because if you do eat it’s possible that you’ll vomit during the operation. They’d rather not risk it. If you need emergency surgery, they’ll place a tube in your throat to protect you from vomiting into your lungs. Putting the tube in can cause problems on it’s own, so they’d rather not do it, but they will if they have to.
The risk from food being present is the same in both cases, the only difference is that in an emergency that risk is *worth it*.
With emergency surgery, your options are “don’t operate and die” or “do operate and small chance the food will cause a complication”. **The food being there isn’t somehow “OK” now, it’s just** ***tolerable*** **because the no-surgery option is even worse**. You do the surgery because even *with* the increased risk from the food, the person has a better overall chance of living if you operate vs. if you don’t.
Whereas with routine surgery, you can remove this risk from the food right down to 0 by simply not eating before surgery, so why wouldn’t you?
Having a belly full of food increases the risk of the surgery either way. It’s not just OK because it’s an emergency surgery, it’s just that because it’s an emergency you have no choice. You have to take the risk.
Eating before going under for surgery increases the risk of throwing up and inhaling your vomit, causing choking and airway damage. The risk is small, but obviously good to avoid. So they have a policy of no eating before a scheduled surgery.
If it’s a case of “surgery needs to happen ASAP or the patient will die”, they’re going to weigh that higher than the smaller risk of vomit/choking
When you come in and you need emergency surgery, they protect your airway and sometimes use a gastric tube to pull out what they can. It’s not ideal though, and it’s much safer to not have to deal with it.
Emergency surgery will not be postponed because a patient has eaten. Nil-by-mouth is simply a strategy to reduce the risk of death during surgery but it isn’t always possible to wait, such as in an emergency. Food in your stomach is a risk because anaesthetic drugs can cause vomiting, and when someone is unconscious and lying on their back, this can easily be fatal. This is a risk however and not guaranteed to occur whether they have eaten or not. Having an empty stomach means if the patient does vomit, there’s no bits of food to get stuck in the airway. If the risk to the patient from not operating is higher then the risk of having stomach contents during anaesthesia, then they will of course operate and chose the option with least risk to the patient.
Medicine at it’s core is risk management.
There is no 100% safe treatment or medicine, but they can be significantly safer than your illness. Which is why doctors use them.
You can look at it like playing “Rock, Paper, Scissors”; in the case of a scheduled surgery where you don’t eat, and they do prep. The surgery staff will try and stack the deck in your favour, so when you play it’s best 3 out of 5 and your opponent(Death) is only allowed to use “Rock” and “Scissors”.
However, in an emergency, they don’t have this luxury. The only choice they have is for you to automatically lose(die), or they can bring you to the table and at least try to give you a chance to play a regular game and hope you can pull through.
All these answers about vomiting and aspirating and here I thought it was because empty stomachs make anesthesia calculations more secure so the patient doesn’t wake up.
The thought of waking up during surgery was wild enough but the thought of choking on vomit is even worse.
Related question: when I had to have an extremely emergent C section that I needed to be put fully under for, they had me drink a shot of some nasty liquid since I hadn’t been fasting and had eaten somewhat recently. What is this liquid and does it somehow lessen chances of vomiting/aspiration?
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