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Which of the following IS a good candidate for natural airway sedation?

a) A 10 year-old with a history of TE fistula (repaired) with long-term stricture of
the esophagus, requiring endoscopic dilation of the esophagus

b) A 6 month-old asymptomatic infant for colonoscopy and upper endoscopy due
to family history of disseminated GI malignancy

c) A 21 month-old for concern for magnet foreign body ingestion for upper
endoscopy

d) A 14 year-old with history of recurrent nausea and vomiting for upper
endoscopy and colonoscopy

e) None of the above
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==Answer==
Answer e. Individual patient factors, surgeon preference, anesthesiologist
preference, and venue characteristics should all weigh in to the decision to
intubate the trachea or not for GI endoscopy surgery. Patients with protracted
vomiting, esophageal stricture or active foreign bodies are at increased risk of
aspiration events and this risk is at least partially decreased by endotracheal
intubation. Small infants (as in patient B) are at risk for tracheal compression
during upper endoscopy and maintenance of a patent airway is also very
challenging during these procedures in infants; the conservative management
strategy is to secure the airway for this patient.
==Notes==
<references />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.
==Keywords==
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