Defying Pediatric Fasting Guidelines

Doctors and nurses provide procedural sedation to children in a variety of settings-emergency, outpatients, and inpatient units. Procedure guidelines exist in both North American and Canadian Association of Anesthesiologists. Not all providers of procedural sedation adhere to these guidelines. A systematic review of the literature was conducted with the aim of finding evidence supporting pre-operative fasting. Studies were evaluated from electronic databases. No evidence existed to support pulmonary aspiration from vomiting; however, children at risk may be more prone to aspiration. Best practice for nurses providing safe care for children receiving procedural sedation involves: head-to-toe assessment, airway management skills, monitoring vital signs, pulmonary auscultation, and knowledge about resuscitative medications, intravenous equipment, and pharmacologic antagonists.