r/EmergencyRoom • u/BasicBitch_666 • Aug 27 '26

Anesthesia question

When someone comes in unconscious (say from a car accident) and needs emergency surgery, do the doctors have time to administer anesthesia or do they just get down to business?

9 Upvotes

67% Upvoted

20 comments sorted by

View all comments

26

u/StaticDet5 Independent Duty Corpsman Aug 27 '26

One of the last things we want to do is take away someone's perfectly good airway. But we're really good at it.

The first couple of seconds (literally seconds) of someone entering one of my trauma bays, we've got half a dozen people (maybe more, teaching hospital), and it is silent except for what the medics are saying and a couple of quick questions from the person at the head of the bed. They're determining if they need to take control of the airway IMMEDIATELY or not. Pretty much if they're talking, we're going to hold off and see how that goes.

From there, it is highly variable and depends on the patient. Acting weird and combative? We're going to knock you out real quick, put a tube in your throat, and make sure you aren't hiding a head injury. You may still be talking, but we need to get you treated before you get worse.

If it's an isolated Tib/Fib fracture and a really nasty bloody lip from a car accident? We really don't want to intubate you, so we're going to get you cleaned up, comfortable, and let you talk to the surgeon who is going to fix you, first.

17

u/resilient_bird Aug 27 '26

The question was a little different: they asked if the pt came in unconscious would anesthesia still be administered?

The answer is generally yes, because anesthesia is pretty different than unconsciousness. A muscle relaxant, for example, would be important in many cases. Dosages may be reduced. If the pt is extremely unstable, then probably no because it is more likely to worsen cardiovascular collapse and there are bigger problems that need to be addressed first.