“Full Stomach” Despite the Wait: Point‐of‐care Gastric Ultrasound at the Time of Procedural Sedation in the Pediatric Emergency Department

• DOI: 10.1111/acem.13651
• Publication Date: 2018-10-29T19:19:56Z
• Authors: Julie Leviter; Dale W. Steele; Erika Constantine; James G. Linakis; Siraj Amanullah
• Keywords: Gastric Content

Abstract Objectives The objective was to use gastric point‐of‐care ultrasound ( POCUS ) assess contents and volume, summarize the prevalence of “full stomach,” explore relationship between fasting time at procedural sedation. Methods This a prospective study patients aged 2 17 years prior A single sonographer scanned each patient's antrum in two positions: supine with upper body elevated right lateral decubitus RLD ). Gastric content (empty, liquid, or solid) noted, volume mL /kg) estimated from antral cross‐sectional area CSA “Full stomach” defined as any solid >1.2 /kg liquid content. Results We enrolled 116 subjects, median 5.8 hours. Of 107 evaluable images, 74 patients, 69% (95% confidence interval [ CI ] = 60%–77%), were categorized having full stomach. Each hour associated lower odds (odds ratio 0.79, 95% 0.65–0) However, knowledge alone provides little ability discriminate risk groups (C‐index 0.66). Conclusions classified many stomach expected sedation, despite prolonged times. These findings may inform risk–benefit considerations when planning timing medication choice for