Observational studyCJEM2026
Sonographic assessment of fasting: emergency room sedations.
Observational study in CJEM, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAspiration during emergency department (ED) procedural sedation is exceedingly rare but remains a key safety concern. Assessment of aspiration risk is a fundamental element of sedation risk assessment, yet fasting status, a common surrogate, has limited predictive value. This study evaluated whether self-reported fasting reliably predicts gastric contents in adult ED patients, as assessed by point-of-care ultrasound (PoCUS).
methodsWe conducted a prospective observational study of adults presenting to a Canadian academic ED (Aug 2024-May 2025). Participants reported their last oral intake and underwent gastric PoCUS using standardized imaging. Three blinded reviewers classified contents as low risk (empty/clear fluids) or high risk (solids). The primary outcome was the presence of solid gastric contents relative to fasting duration.
resultsA total of 122 participants (mean age 52.2 years; 51.6% female) were enrolled. The gastric antrum was visualized in all cases, with strong inter-rater reliability (κ = 0.79). Solid contents were present in 78.9% of patients fasting less than 8 h and 58.1% fasting greater than 8 h (risk difference 20.8%, p = 0.014). The prevalence of solid contents declined with increasing fasting time: 92% at 0-4 h, 68% at 4-8 h (p = 0.049), and 58% at greater than 8 h (p = 0.012). Mean fasting duration was shorter in patients with solids (9.4 h) compared with those without (13.4 h).
conclusionSelf-reported fasting duration was an unreliable predictor of gastric contents, with more than half of patients fasting for greater than 8 h still demonstrating solids on PoCUS. Gastric PoCUS may offer an accurate adjunct for assessment of gastric contents in patients undergoing ED procedural sedation.
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Registered trials
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