Risks of sedating

If you were going to be stuck in a dark, cool cargo area near a roaring airplane engine, you would want to be sedated.So it would be natural to assume your pet would prefer this as well.The following are facts about fasting and aspiration risk.FACT 1 – Aspiration Is A Real Risk: aspiration is not theoretical – whilst uncommon, it happens and patients occasionally suffer serious morbidity or mortality from it.Regardless of the reason for this difference of opinion I think its worthwhile stating a few facts on the issue.For those of you who have access I had a great & detailed discussion with Andy Buck about fasting, airway management & procedural sedation recently on the May Aussie Edition of EMRAP.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).

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The seriousness of lung damage produced by aspiration is dependent on the volume & composition of the aspirate with low p H material producing a higher risk of aspiration pneumonia and with aspiration of solid material being much more likely to result in mortality.

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.

The function of sedation is management of anxiety, pain, and control of excessive motion.

Diagnostic procedures for which emergency department (ED) sedation may be indicated include the following: Discussion about the risks, benefits, and alternatives with the parent or guardian is necessary before initiation of procedural sedation.

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