October 2022

Abstract 1: Laryngospasm During Pediatric Procedural Sedation

EMA 2022 October24 Chapters

  1. Introduction8:04
  2. Ultra Summary30:05
  3. Time to Talk a Little Nerdy: Diagnostic Uncertainty18:44
  4. Farewell3:05

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Sean R. -

One of the frequent EM:RAP contributors has noted that true laryngospasm occurs on the level of being case reportable and that the vast vast majority are not actual spasm but rather glottic closure that impedes breathing as well as BVM use and there is not VL documentation of seeing the cords slapping together in actual spasm. Listening to the episode their definition of laryngospasm seemed to focus on lack of air movement not relieved by chin repositioning or an OPA/NPA. I struggle a bit connecting the dots as to how this is by definition actual laryngospasm or how this combination of criteria is by default laryngospasm (obviously one has to make the leap that laryngospasm in the true sense of spasm exists) and not another etiology causing the symptoms.

Rosy K. -

With the N of this prospective study, and the 3/1000 rate, with ED prevalence being much lower ( underreporting, others biases , ?)
I think the clinical significance is not of absolute risk reduction but of how safe this procedure is. Kudos to the 1000s of authors and teachers who furthered the research , quality , and safety of this procedure.

Mike M. -

Totally agree with both above comments. The literature demonstrates overwhelmingly that laryngospasm, even using an extraordinarily generous definition, is even more extraordinarily rare.

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EMA 2022 October Full episode audio for MD edition 192:42 min - 195 MB - M4AEMA 2022 October - Abstracts PDF 701 KB - PDFEMA 2022 October - MP3s 241 MB - ZIPTime to Talk a Little Nerdy: Diagnostic Uncertainty 217 KB - PDF

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