Point of Care Ultrasound Gastric Assessment

Abstract

Aspiration pneumonia is one of the most prevalent causes of morbidity and mortality in anesthesia, responsible for almost half of all airway-related anesthesia complications (Perlas et al., 2018; Sharma et al., 2018; Warner et al., 2021). Current practice utilizes nil per os (NPO) guidelines to determine the patient’s stomach content; however, a review of the literature reveals that maintaining rigid fasting guidelines has little correlation with gastric volumes, leading to misdiagnosis of aspiration risk (Miller et al., 2021; Ohashi et al., 2018). Compared to current NPO guidelines, point-of-care ultrasound (POCUS) gastric assessment identifies high-risk patients, enhancing sensitivity and specificity. Mainstreaming POCUS gastric assessment as a standard tool to identify high-risk aspiration patients in the preoperative phase may allow the anesthesia team to modify the plan of care. This can help providers tailor the anesthesia plan to individual patient status and comorbidities, allowing for decreased risk of aspiration and subsequent consequences. The literature promotes POCUS gastric assessment as the new standard of care, potentiating a safer anesthesia plan in up to 50% of procedures (Delamarre et al., 2021; Shorbagy et al., 2021; Van de Putte et al., 2018). This project aims to create a continuing education (CE) module on utilizing POCUS gastric assessment and submission for approval by Echelon and the American Association of Nurse Anesthesiology (AANA) accreditation.

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