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Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions?

Publication ,  Journal Article
Cieslak, JR; Rice, AN; Gadsden, JC; Vacchiano, CA
Published in: AANA J
April 2020

The presence of gastric content before induction of general anesthesia is the primary modifiable risk factor in the prevention of pulmonary aspiration. The purpose of this project was to determine if ultrasonography could be routinely used to measure gastric content and assign aspiration risk in patients undergoing general anesthesia. Preoperative gastric ultrasonography was performed in a convenience sample of 100 patients. A group of Certified Registered Nurse Anesthetists, anesthesia residents, and anesthesiologists were asked their plan for airway management before and after receiving the results of the patients' gastric ultrasonogram, to determine if the scan would alter the plan. In 14% of patients scanned, solid gastric content was observed, 7% had clear liquids present, and 79% had an empty stomach. Of the patients with clear liquids present, 3 had substantial (> 100 mL) gastric content despite following fasting guidelines. Overall, there was a 9% change in airway management from standard induction: 6% changed to modified rapid sequence intubation (no ventilation, no cricoid pressure), and 3% changed to rapid sequence intubation with cricoid pressure. The number of changes to the airway management plan and identification of several patients with substantial gastric content demonstrate the value of preoperative gastric ultrasonography in airway management decision making.

Duke Scholars

Published In

AANA J

EISSN

2162-5239

Publication Date

April 2020

Volume

88

Issue

2

Start / End Page

107 / 113

Location

United States

Related Subject Headings

  • Ultrasonography
  • Surveys and Questionnaires
  • Preoperative Period
  • Practice Patterns, Nurses'
  • Nurse Anesthetists
  • North Carolina
  • Middle Aged
  • Male
  • Humans
  • Gastrointestinal Contents
 

Citation

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Cieslak, J. R., Rice, A. N., Gadsden, J. C., & Vacchiano, C. A. (2020). Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions? AANA J, 88(2), 107–113.
Cieslak, Jamie R., Andi N. Rice, Jeffrey C. Gadsden, and Charles A. Vacchiano. “Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions?AANA J 88, no. 2 (April 2020): 107–13.
Cieslak JR, Rice AN, Gadsden JC, Vacchiano CA. Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions? AANA J. 2020 Apr;88(2):107–13.
Cieslak, Jamie R., et al. “Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions?AANA J, vol. 88, no. 2, Apr. 2020, pp. 107–13.
Cieslak JR, Rice AN, Gadsden JC, Vacchiano CA. Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions? AANA J. 2020 Apr;88(2):107–113.

Published In

AANA J

EISSN

2162-5239

Publication Date

April 2020

Volume

88

Issue

2

Start / End Page

107 / 113

Location

United States

Related Subject Headings

  • Ultrasonography
  • Surveys and Questionnaires
  • Preoperative Period
  • Practice Patterns, Nurses'
  • Nurse Anesthetists
  • North Carolina
  • Middle Aged
  • Male
  • Humans
  • Gastrointestinal Contents