Ketamine Sedation in Children

Author: Gavin Lloyd / Editor: Jason M Kendall / Reviewers: Jon Bailey, Nadarajah Prasanna, Sarah Gooding / Codes: / Published: 15/05/2020 / Reviewed: 12/07/2024

This module is based upon the RCEM College Best Practice guideline on Ketamine Procedural Sedation for Children in the Emergency Department (ED).

After completing this session you will be able to:

  • Judge when ketamine sedation is appropriate
  • Safely use ketamine following the College guideline
  • Troubleshoot any complications arising
  • Consider governance issues regarding ketamine sedation in your department

References

  1. Green SM, Rothrock SG, Lynch EL, et al. Intramuscular ketamine for pediatric sedation in the emergency department: safety profile in 1,022 cases. Ann Emerg Med. 1998 Jun;31(6):688-97.
  2. Agrawal D, Manzi SF, Gupta R, Krauss B. Preprocedural fasting state and adverse events in children undergoing procedural sedation and analgesia in a pediatric emergency department. Ann Emerg Med. 2003 Nov;42(5):636-46.
  3. Royal College of Emergency Medicine (RCEM). Ketamine Procedural Sedation For Children In The Emergency Department. Best Practice Guideline. Revised: Feb 2020.
  4. Menegazzi JJ, Paris PM, et al. A randomized, controlled trial of the use of music during laceration repair. Ann Emerg Med. 1991 Apr;20(4):348-50.
  5. Zelter L, LeBaron S. Hypnosis and non-hypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer. J Paediatrics 1982;101:1032-1035.
  6. Kuttner L. Management of young children’s acute pain and anxiety during invasive medical procedures. Pediatrician. 1989;16(1-2):39-44.
  7. FFrench GM, Painter EC, Coury DL. Blowing away shot pain: a technique for pain management during immunization. Pediatrics. 1994 Mar;93(3):384-8.
  8. Harrison A. Preparing children for venous blood sampling. Pain. 1991 Jun;45(3):299-306. doi: 10.1016/0304-3959(91)90054-2.
  9. Langston WT, Wathen JE, Roback MG, Bajaj L. Effect of ondansetron on the incidence of vomiting associated with ketamine sedation in children: a double-blind, randomized, placebo-controlled trial. Ann Emerg Med. 2008 Jul;52(1):30-4.
  10. Newman DH, Azer MM, Pitetti RD, Singh S. When is a patient safe for discharge after procedural sedation? The timing of adverse effect events in 1367 pediatric procedural sedations. Ann Emerg Med. 2003 Nov;42(5):627-35.

Leave a Reply