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Discussion

The Practice of GERD

Although I know, "What do you do?" questions are fraught with difficulty in anesthesia, I thought it might be fun to do a little poll regarding anesthesia and GERD.

So to all the anesthesia providers out there, what is your current practice? Do you always or most always play the conservative game and RSI and MRSI when a patient has GERD? Or, do you base your judgement on the severity of the patients symtoms? Would you use the Sellick maneuver if the patient was controlled on meds? Do you use cricoid pressure on all diabetics, or only if they have symptoms?

Presently, I perform RSI on GERD patients who are more than rarely symptomatic. There are two sides to the issue, so what is yours?

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RSI anyone with frequent GERD. If the medication is controlling it, or they rarely have an episode then I use a standard induction.

although i have only been in clinical a month now, most of the people i work with function on the priciple that if the patient has a history of gerd, they get rsi, and cricoid. most feel it is better to be safer than have to explain yourself to a jury when the patient aspirates and you knew from their history they had gerd. better safe than sorry.

imho.

d

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