Key result
Interval of eating to injury was the most used (88%) criterion for predicting gastric safety following trauma, whereas presence or absence of bowel sounds was the least used (7%).
Why the study?
What criteria do anaesthetists use to predict gastric safety and the risk of pulmonary aspiration following trauma?
Cross-Sectional (n=195)
What criteria do anaesthetists use to predict gastric safety and the risk of pulmonary aspiration following trauma?
There is little evidence supporting the criteria currently used by anaesthetists to accurately identify trauma patients at risk of pulmonary aspiration.
Reliance on unvalidated criteria for gastric safety post-trauma warrants caution; leaves open rigorous validation of aspiration predictors.
Trauma is often assumed to increase the risk of pulmonary aspiration of gastric contents. The 247 anaesthetists in the Trent region of England were surveyed by postal questionnaire to ascertain the current practice for identifying patients at risk of pulmonary aspiration of gastric contents following trauma. The response rate was 79%. The anaesthetists rated the reliability of several criteria when predicting 'gastric safety' and stated whether each criterion formed part of their clinical practice. Interval of eating to injury was the most used (88%) and highest rated criterion (4/5) followed by use of opioids. Presence or absence of bowel sounds was the least used (7%) and lowest rated criterion (0/5). Currently there is little evidence that the commonly used criteria accurately identify 'at-risk' patients. There is little evidence that trauma increases the risk of aspiration although a number of factors associated with trauma are known to delay gastric emptying.
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Hardman et al. (1999) conducted a cross-sectional in Pulmonary aspiration of gastric contents following trauma (n=195). Criteria for predicting gastric safety was evaluated on Use and perceived reliability of criteria for predicting gastric safety. Interval of eating to injury was the most used (88%) criterion for predicting gastric safety following trauma, whereas presence or absence of bowel sounds was the least used (7%).