Why can you not eat before a scheduled surgery but in the event of say an emergency surgery it’s ok if you’ve eaten?

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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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29 Answers

Anonymous 0 Comments

Anesthesiologist here.

We like patients to be optimized. That doesn’t mean 100% healthy or prepared for surgery but it does mean as healthy or as prepared as a person can be. This means limiting risks. There’s a small chance a person will vomit on induction of anesthesia(there’s many reasons why this can happen but beyond the scope of this answer).

When a person vomits there’s a chance the vomit goes into their windpipe and reaches the lungs. This can cause an inflammatory or infectious reaction leading to breathing problems, lung inflammation or pneumonia. The things that cause this problems more are low pH (stomach acid and digestive enzymes) and particulates (food). If you fast you’re less likely to have these in your stomach and less likely to have a bad outcome if you vomit. It doesn’t happen every time but like I said, I want you as safe as possible.

When there’s an emergency we weigh the risk vs benefit. So if you’ve been shot and will die if we don’t operate but have a burger in your stomach I’ll say well some pneumonia is less bad than bleeding to death please operate. But if you’re showing up for a scheduled knee replacement I may say let’s wait for the stomach to empty since this surgery isn’t life or death and I can make you safer for surgery.

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