The gag reflex

PulmCrit (EMCrit)

The gag reflex shouldn’t be tested in living patients

PulmCrit - July 4, 2017 -  ::By Josh Farkas 

"Summary: The Bullet

• The gag reflex is a traditional component of the neurologic examination, but isn't evidence-based.
• The reproducibility of the gag reflex is poor, due to variation in the techniques used to elicit it.
• The specificity of the gag reflex is poor, being absent in ~20% of younger patients and ~40% of elderly patients.
• The gag reflex is an unreliable predictor of aspiration, because it tests only a small fraction of the nerves and muscles required to control secretions via swallowing.
• The gag reflex should not be used to assess whether patients can protect their airways.
• The only rational use of the gag reflex appears to be certification of brain death."