We have a large collection of children's cases using IV Ketamine. We have
moved to this route mainly as we have found it to give more reliable onset
and cleaner finish to discharge. Precautionary IV access is recommended using
the IM route - which mat be gained following onset of sedation but which may
not be as easy then due to peripheral vasoconsriction.
We use atropine to counteract salivation but also to avert any vagal effect
during these procedures - to which children may be particularly suseptible.
IV acess is much easier now that Ametop is available. I know of no
contraindication to its use in this setting - unless you count getting it in
your eye - which isn't nice. We give atropine with midazolam, IV, prior to
the Ketamine.
Charles Fee
Craigavon
N.Ireland
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