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Procedural sedation laryngospasm — RCPSC EM MCQ

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ModerateResuscitation, procedures, airwayProcedural sedation laryngospasmRCPSC EM

CTAS 1. A 6-year-old undergoing ketamine sedation for fracture reduction develops stridor and chest wall retractions. SpO2 falls from 99% to 86%. There is no vomit in the mouth and bag-mask ventilation is difficult. What is the most appropriate next step?

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Correct answer: A — Airway repositioning, CPAP, suction, then positive pressure as needed

Laryngospasm during sedation requires stopping stimulation, airway manoeuvres, suction, CPAP or positive pressure, and escalation if unresolved.

Reference: Canadian Association of Emergency Physicians procedural sedation resources