Block It Like It’s Hot: Regional Anesthesia, Pain Medicine & POCUS S2:E3 "POGUS or BOGUS? Gastric Ultrasound for Hungry Doctors!"
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Apr 15, 2024 Explore the intriguing world of gastric point-of-care ultrasound as the hosts uncover its significance in anesthesia. Discover how POGUS can transform fasting guidelines and influence preoperative decisions, including airway management. They delve into the history and techniques of gastric ultrasound while distinguishing between various gastric contents. Listen as they evaluate the clinical studies supporting POGUS and discuss its limitations, alongside practical workflow tips for optimizing patient safety.
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GLP‑1 Agents Cause New Aspiration Risk
- GLP-1 agonists have increased concern about delayed gastric emptying and unexpected full stomachs.
- Point-of-care gastric ultrasound (POGUS) can quickly identify patients at higher aspiration risk despite fasting.
Scan Supine Then Right Lateral
- Scan the gastric antrum in midline sagittal under the xiphoid to answer if the stomach is empty or not.
- If supine view is empty, always re-scan in right lateral decubitus because fluid can settle into the antrum.
Three‑Tier Stomach Grading
- A qualitative grading (0/1/2) classifies empty, small clear fluid, or significant fluid/solids to guide risk.
- Grade 0/1 are commonly low risk while solids or supine fluid (grade 2) indicate high aspiration risk.