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Procedural sedation adverse event — ABEM Board MCQ

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ModerateProcedures and resuscitationProcedural sedation adverse eventABEM Board

A 16-year-old boy undergoing forearm reduction after ketamine develops laryngospasm. Triage acuity is ESI 1; SpO2 drops to 78%, HR 118/min. He has inspiratory obstruction and no effective chest rise. Suction is ready at bedside. Which of the following is the most appropriate initial action?

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Correct answer: D — Apply airway maneuvers with positive-pressure ventilation and prepare for paralysis if persistent

Laryngospasm during sedation is managed with airway positioning, suction, positive-pressure ventilation, and escalation to paralytic-assisted airway if unresolved.

Reference: ACEP Procedural Sedation and Analgesia clinical policy