Answer
Discussion about the risks, benefits, and alternatives with the parent or guardian is necessary before initiation of procedural sedation. 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. Recommendations for duration of NPO for solid food and nonclear liquids (eg, infant formula, milk) vary by age, as follows:
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< 6 months: 4-6 hours
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6-36 months: 6 hours
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>36 months: 6-8 hours
Suction and airway equipment should be at the bedside and ready to use if necessary. Equipment should include the following:
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An appropriately sized positive-pressure oxygen delivery system
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Suction apparatus
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Suction catheters (eg, tonsil, Yankauer)
The following equipment should be readily available:
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Age-appropriate equipment for measuring blood pressure and oxygen saturation
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A crash cart with age-appropriate drugs and equipment
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Mallampati classification.
