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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Your stomach and your lungs share the same driveway (your throat). This is both good (saves real estate space) and bad (your stomach contents could end up in your lungs if they decide to reverse out). Stomach contents are pretty acidic and they do some real damage to the lungs if they end up there. Good news is that when you vomit your body does some pretty smart and slick manoeuvres (which I am sure you have realised you have no control over) to make sure your stomach contents end up in the toilet and not in your lungs. Unfortunately when you are deeply unconscious (or under anaesthetic) your body loses the ability to do this.

So anaesthesiologists have come up with some steps to try and prevent this from happening. The most successful step is to starve you for a few hours before your anaesthetic and let your stomach empty itself (in the right direction). This works pretty well when we all know when the surgery is going to be.

However when the surgery is an emergency, we often (not always) can’t wait for the staving period AND the problem you are coming to surgery for often means the normal starving period won’t be long enough to drain your stomach anyway.

So a few smart guys in the 1970s came up with a way around this. Basically they follow a clear sequence of steps, very rapidly, to put you to sleep and place a tube into your windpipe. To be extra safe, they also inflate a ballon attached around the tube to totally block off the lungs from the throat. So now even if your stomach contents decides to reverse out all over the place, it won’t be able to get into your lungs.

At the end of the surgery they will suction your mouth and throat in case there are stomach contents there, deflate the balloon and pull the pipe out.

So why don’t they just do that for everyone? Basically that rapid sleeping method can cause quite a few other problems, like, with your blood flow and oxygen delivery. So if they don’t have to do it, they would rather not.

Last thing: even with all the steps is there still a chance the stomach contents can sneak into the lungs between the time you go under but before the tube is in and the balloon is inflated? Yes. How do they prevent that? They need to be very fast.

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