Sedation with ketamine for paediatric procedures in the emergency department--a review of 500 cases.
Ketamine has been used to "consciously" sedate patients for a variety of paediatric procedures in our department since 1998. This is a retrospective review of the first 500 paediatric patients given ketamine for conscious sedation. Ketamine was given, either intramuscularly (3-4 mg/kg) or intravenously (1-2 mg/kg) together with atropine (0.02 mg/kg), with or without intravenous midazolam (0.05 mg/kg). The main indications for giving ketamine were for laceration repair, especially those of the lip, tongue and buccal mucosa (54.4%); manipulation and reduction of upper limb fractures (25.8%); incision and drainage of abscesses (12%), removal of foreign bodies (6.4%) and a potpourri of other conditions. Seventy-five point six percent of our patients were less than six years old and the male to female ratio was 1.9:1. Ninety-six percent of our patients were discharged home well and only one child (0.2%) was admitted for observation possibly as a consequence of ketamine. We find ketamine to be a relatively effective drug for use for conscious sedation in children.
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Department of Emergency Medicine, KK Women's & Children's Hospital, Singapore. keech@kkh.com.sg
Ang
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SY
D000293:Adolescent; D000778:Anesthetics, Dissociative; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007649:Ketamine; D008297:Male; D008874:Midazolam; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000188:drug therapy
D000778:Anesthetics, Dissociative; D007649:Ketamine; D008874:Midazolam