Guideline for Procedural Sedation in Non‑fasted Children Requiring Urgent CT for Suspected Acute Appendicitis
1. Incidence and Risk of Aspiration
2. Evidence Supporting Sedation Without Complete Fasting
3. Pre‑Sedation Assessment
4. Sedation Strategy
5. Adjunct Techniques to Minimize Sedation Depth
6. Required Emergency Equipment (immediately accessible)
| Equipment | Purpose |
|---|---|
| Age‑appropriate oral and nasal airways | Maintain airway patency |
| Bag‑valve‑mask (BVM) device | Provide manual ventilation if needed |
| Supraglottic airway devices (e.g., laryngeal mask airway) | Rescue airway when mask ventilation insufficient |
| Reversal agents specific to the sedative used (e.g., flumazenil for benzodiazepines, naloxone for opioids) | Rapid antagonism of drug effects |
All items must be readily available in the procedural area [1][5]3.
7. Common Pitfalls to Avoid
8. Risk‑Benefit Summary
Overall, the benefit of urgent diagnostic imaging outweighs the minimal aspiration risk, supporting the use of carefully titrated, shallow sedation even in non‑fasted pediatric patients.