Abstract
<jats:p>Aspiration under anaesthesia is the most common cause of airway-related mortality. The perceived risk of aspiration influences anaesthetic management, theatre efficiency, and theatre utilisation. Despite adherence to risk mitigation strategies, many anaesthetists will still experience a significant aspiration event in their career. Given its incidence, there is limited evidence on how to best manage and train for aspiration under anaesthesia. While acknowledging the paucity of evidence, this article will examine the literature with the intention of stimulating discussion about the potential for the expedient use of intraoperative bronchoalveolar toileting (BAT) and, perhaps, rationalisation of local guidelines elsewhere in Australia and New Zealand. A local protocol at the authors’ institution (Fiona Stanley Hospital in Perth) was recently developed to empower anaesthetists to perform BAT in the early management of aspiration. This was developed by anaesthetists, in conjunction with intensive care and respiratory physicians, and presented as workshops at national conferences. This protocol will be presented as a practical example with opportunity for adaptation and adoption at other locations.</jats:p>