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I have to disagree with the routine use of benzodiazepines (midazolam, diazepam) with ketamine. The evidence shows that it does not reduce the incidence of emergence phenomena in children and introduce other complications like disphoric reactions and desaturation. (I posted the references of two good studies on the matter in a previous e-mail a couple of days ago). I you encounter a emergence phenomena that cannot be managed with a quiet enviroment , you could give midazolam to particular patient. Andres Izquierdo-Martin Specialist Registrar in Emergency Medicine North Thames (East) Region ----- Original Message ----- From: "Tony Adams" <[log in to unmask]> To: <[log in to unmask]> Sent: Friday, February 16, 2001 6:10 PM Subject: Re: chemical restraint > I have seen emergence phenomenon with ketamine in one adult whom I'd given > ketamine to under a tube-train for extrication and an older child - 10 years > old, give ketamine for suturing a nasty wound. Both were quite scary. > I think that if ketamine is used for chemical restraint an 'azepam must be > used in conjunction to avoid exacerbating the presenting symptom. > > > Tony Adams > Peterborough Dist. Hosp. > --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.230 / Virus Database: 111 - Release Date: 25/01/01