 Similarly, in an observational study no patient developed pulmonary aspiration. A Cochrane review did not show an increased risk of pulmonary aspiration with shorter fluid fast. A review article did not report an increased risk of pulmonary aspiration in non-fasted patients in the emergency department. However, a prospective multicenter emergency-department study of 2623 patients revealed only one patient developed aspiration pneumonia following the use of sedation. There is current consensus in the anesthesia literature that it is safe for healthy individuals to drink clear fluids up to 2 hours before induction of general anesthesia. It is recommended that 2 hours fasting for clear fluids, 6 hours for solids and supports the concept of pre-operative oral nutrition using a special carbohydrate-rich beverage. On the other hand, coronary procedures require the use of intravenous contrast, which can precipitate acute renal impairment. It has been shown that proper hydration can reduce the risk of contrast-induced nephropathy. A review study suggests that the oral route is as effective as the intravenous route for volume expansion and reduction of contrast-induced acute kidney injury. A prospective study demonstrated that lack of fasting was not associated with a higher incidence of adverse events in children undergoing pre-procedural sedation in the emergency department. A recent clinical policy published by the American College of Emergency Physicians; has recommended Level B, that procedural sedations in emergency departments should not be delayed based on fasting status. 