Answer
An evaluation of a patient for procedural sedation begins with a thorough history and a careful physical examination.
Important elements of the history are as follows:
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Past medical history, especially with respect to previous sedation or anesthesia
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Last solid and liquid oral intake
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Recent illness
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Medication or drug use
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Allergies or adverse reaction
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Pertinent family history
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Pregnancy status (for postmenarchal females)
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Upper respiratory infection (URI) symptoms; history of reactive airway disease
Elements of the physical examination are as follows:
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Age
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Weight
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Vital signs
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Airway examination (head, ears, eyes, nose, and throat [HEENT] and pulmonary examination)
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Cardiovascular examination
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Neurologic/mental status
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Size and location of injury and neurologic status distal to it
The physical examination focuses on the airway, especially for anatomic variations. The use of the Mallampati classification (see the image below) for assessment helps identify patients in whom airway management is likely to prove difficult.
Mallampati classification.
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Mallampati classification.
