Push here to save the day: Laryngospasm Notch

Laryngospasm is a rare but well know complication of using ketamine for conscious sedation, particularly in young kids. Treatment for this involves the usual maneuvers:

• Chin lift 
• Jaw thrust 
• Suction
• Positive pressure ventilation via bag-mask, occluding pop-off valve if necessary to generate high enough pressures to open the vocal cords 
• Neuromuscular blockade 

Another helpful albeit less well known technique that can be tried is application of pressure to the laryngospasm notch.

The mechanism by which this technique works is uncertain but it is endorsed in the anesthesia literature.  Click here to read a good review of this technique by Dr. Philip Larson, a Professor Emeritus of Anesthesia and Neurosurgery at Stanford.


Source

Gorelick, M et al.  "Pediatric Sedation Pearls"  Clin Ped Emerg Med. Dec 2007.

Larson, P. "Laryngospasm - The Best Treatment"  Anesthesiology.  Nov 1998.