Vom iting and regurgitation
Rescuers should always be alert to the risk of contamination of the unprotected airway by regurgitation or vomiting of fluid or solid debris. Impaired consciousness from anaesthesia, head injury, hypoxia, centrally depressant drugs (opioids and recreational drugs), and circulatory depression or arrest will rapidly impair the cough and gag reflexes that normally prevent tracheal soiling.
Vomiting is an active process of stomach contraction with retrograde propulsion up the oesophagus. It occurs more commonly during lighter levels of unconsciousness or when cerebral perfusion improves after resuscitation from cardiac arrest. Prodromal retching may allow time to place the patient in the lateral recovery position or head down (Trendelenburg) tilt, and prepare for suction or manual removal of debris from the mouth and pharynx.
Regurgitation is a passive, often silent, flow of stomach contents (typically fluid) up the oesophagus, with the risk of
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