Recommendations for duration of NPO for solid food and nonclear liquids (eg, infant formula, milk) vary by age, as follows: The physical examination focuses on the airway, especially for anatomic variations.
The use of the Mallampati classification for assessment helps identify patients in whom airway management is likely to prove difficult (see the image below).
Procedural sedation may be defined as the administration of sedative or dissociative agents, with or without analgesics, to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function.
Specifically, the drugs, doses, and techniques used are not likely to produce a loss of protective airway reflexes.
The need for written consent may be determined by an institutional, local, or state mandate.
Children of all ages should be NPO for clear liquids 2 hours before undergoing sedation.
For example, ketamine may cause ataxia for 12-24 hours, and the child’s activities should be restricted during this period to prevent further injury.The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) have issued updated clinical guidelines on the monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures.The guidelines include the following Pain and anxiety are common problems in the emergency department (ED).By relieving pain, the emergency provider can render the patient less anxious and more cooperative, thereby potentially achieving a better outcome.
After the completion of the procedure, keep recording vital signs until the patient responds appropriately to a voice or gentle stimulation.Sedation is stimulus-dependent; accordingly, when the procedure is completed, the child is likely to become more sedated than during the procedure, which can lead to hypoventilation and hypoxia.