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Original Contributions
June 15, 1964

Preventing Aspiration Deaths During Anesthesia

JAMA. 1964;188(11):971-975. doi:10.1001/jama.1964.03060370027006

Aspiration of gastric contents during general anesthesia is often fatal but is preventable. Obstetrical patients and patients requiring emergency surgery most often have a "full stomach." Prevention of aspiration in such patients can be approached positively, by inserting an endotracheal tube before induction of general anesthesia, or negatively, avoiding general anethesia and substituting "conduction" anesthesia. Examination of possible approaches to the "full stomach" leads to a conclusion that risks associated with some anesthetic techniques are unwarranted except in rare instances. Technique of "awake intubation" is described and contraindications to its use are outlined.