[A child with a full stomach has to be anaesthesized].
In the present paper the problem of giving anaesthesia to a child with a full stomach is discussed using a case report. Children are not by nature more in danger of aspiration than grown-ups. Even the higher risk of aspiration in children with a full stomach, which seems plausible, is not proven in all published studies on this subject. Since there is a more or less large amount of residual gastric secrete even 6 - 10 hours after the accident, due to stress or opioids, and prophylaxis against aspiration must be taken in any case, narcosis for the emergency treatment of these children can be applied immediately at the same risk. Rapid sequence induction is the world-wide standard as prophylaxis against aspiration today. Should aspiration happen, bronchoscopic draining is the main measure. Artificial ventilation is not a cogent measure, if the airway is free as far as the visible segmental bronchus and there are no disruptions in the respiratory exchange.
Kretz
F J
FJ
Klinik für Anästhesiologie und operative Intensivmedizin, Olgahospital und Frauenklinik Berg, Klinikum Stuttgart, Germany.
Krier
C
C
D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D001999:Bronchoscopy; D002648:Child; D004322:Drainage; D004632:Emergency Medical Services; D006801:Humans; D011015:Pneumonia, Aspiration / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D012121:Respiration, Artificial; D012306:Risk