Hunger Games: Impact of Fasting Guidelines for Orthopedic Procedural Sedation in the Pediatric Emergency Department

Fasted or Not: Anesthesia-Related Pulmonary Complications in Pediatric Orthopaedic Emergencies Are Rare: A Pilot Study

“…8,9 Fasting status as an independent risk factor for aspiration has suffered from inconsistent evidence in the literature. [10][11][12][13][14][15] In the nonsurgical literature, a recent retrospective review of 2,674 patients undergoing procedural sedation (not general anesthesia) in a large pediatric emergency department by Stewart et al 16 found that 555 patients (21%) not meeting ASA periprocedural fasting criteria had no significant difference in rates of complications compared with the fasted cohort. Modern anesthesia techniques, such as rapid sequence induction (RSI), and airway protection methods, such as cricoid pressure, can further improve the safety of anesthesia for pediatric patients when fasting status is unknown or in doubt.…”