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In the ED: Fasting history is unreliable Treat as higher aspiration risk especially if symptomatic Anticipate vomiting and difficult visualization Practical considerations: Optimize positioning (ramped, head elevated, or slight reverse Trendelenburg) Use RSI when appropriate Minimize bag-mask ventilation Ensure suction is immediately available and functioning

They are lost from the cell together with the degradation of ribosomes and RNA during reticulocyte maturation