Gastric aspirates after trauma in children.

The volumes and pH of gastric aspirates obtained from 110 children (aged 1-14 years) who underwent surgery for trauma were related to the duration of pre-operative starvation and to the interval between food and injury. Aspirates were larger in children fasted for 4-6 hours than in those fasted for up to 10 hours, and were larger in children injured within 2 hours of eating than in those in whom this interval was longer (p less than 0.05). However, 19 of 39 children (49%) starved for over 8 hours had an aspirate of more than 0.4 ml/kg, as did five of 16 children (31%) injured 3 or more hours after eating. Thus, a 'safe' interval between oral intake and induction cannot be predicted. We conclude that securing the airway by prompt tracheal intubation is the safest way to manage any child who presents for emergency anaesthesia after trauma.