[Emergencies and aspiration. Can the usual methods for the prophylaxis of aspiration be further developed? (author's transl)].

There are two prerequisites for aspiration of gastric contents, namely material near the larynx and the possibility for an influx into the tracheobronchial system. We discussed the value of common measures in protecting against aspiration. To take notice of the normal emptying time of the stomach, suction of liquid gastric contents by a stomach tube, evacuation of the stomach by inducing vomiting (large bore stomach tube or apomorphine), mechanical blockade of the oesophagus or of the gastrooesophageal junction, modification of general anaesthesia (induction with an inhalation anaesthetic or intravenous agents), cricoid pressure, foot-down, lateral or horizontal position are not able to prevent the passage of gastric contents into the oro- and nasopharynx. Aspiration is unavoidable if there is a possibility of influx into the tracheobronchial system. Induction of anaesthesia with the patient lying on his left side in the head-down position gives the maximum protection against the danger of aspiration. An easy method of enabling a patient to be placed in the left lateral, head-down position, when only two persons are present, is highly desirable.