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July 2018

Reevaluating Fasting for Procedural Sedation

Author Affiliations
  • 1Department of Emergency Medicine, Loma Linda University, Loma Linda, California
  • 2Division of Emergency Medicine, Boston Children’s Hospital, Department of Pediatrics, Boston, Massachusetts
  • 3Harvard Medical School, Boston, Massachusetts
  • 4Department of Anesthesia, Boston Children’s Hospital, Boston, Massachusetts
JAMA Pediatr. 2018;172(7):622-623. doi:10.1001/jamapediatrics.2018.0867

Procedural sedation is widely administered by a variety of practitioners to facilitate painful or frightening procedures in children.1-9 Guidelines9 recommend a minimum period of fasting (nothing by mouth) prior to elective sedation because of concerns about pulmonary aspiration.7-9 These guidelines most commonly mirror thresholds fixed for elective general anesthesia: 2 hours or longer for clear liquids, 4 hours or longer for breast milk, and 6 hours or longer prior for cow milk, infant formula, or a light meal.9

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