Gastric Ultrasound for Airway Management in Emergency Patients

Airway Management Selection Based on Gastric Content and Residual Volume Assessment in Emergency Patients at RSCM: An Ultrasonography Study

This prospective observational cohort study evaluates the association between gastric residual content and volume, assessed by point-of-care gastric ultrasound (PoCUS), and the choice of airway management technique (Rapid Sequence Intubation vs. non Rapid Sequence Intubation) in adult emergency surgical patients at Rumah Sakit Cipto Mangunkusumo (RSCM). Aspiration risk in emergency patients is a critical concern, and this study examines whether objective ultrasonographic findings change clinical decision-making compared to traditional clinical assessment alone.

Emergency patients frequently have delayed gastric emptying, increasing aspiration risk during airway management. Gastric PoCUS allows non-invasive, bedside assessment of gastric content (empty, liquid, solid, or mixed) and volume. This study quantifies gastric antrum cross-sectional area (CSA) using the Perlas formula (GV = 27.0 + 14.6 × CSA - 1.28 × age) and reports whether USG findings influenced the anesthesiologist's plan (RSI or non-RSI).

Inclusion Criteria:

• Emergency patients requiring airway management in the Emergency Operating Room
• Age >18 years

Exclusion Criteria:

• Pregnancy
• Morbid obesity (BMI >40 kg/m²)
• History of prior gastric or esophageal surgery
• Duodenal tube in situ
• Maxillofacial trauma or anticipated difficult airway
• Inability to adequately visualize the gastric antrum on ultrasound