Original article

Accident and emergency department led implementation of ketamine sedation in paediatric practice and parental response

V J Holloway, H M Husain, J P Saetta, V Gautam

Accident and Emergency Department, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire AL7 4HQ

Correspondence to:
Dr Holloway

Objective—To evaluate accident and emergency (A&E) department led practice of ketamine sedation for painful, short procedures in the paediatric population and to ascertain parental response.

Methods—Analysis of retrospective data for all children who received ketamine sedation over a 20 month period in a district general hospital. A data extraction form was used to record age, sex, dose, indication, side effects, and outcome. The parents were contacted by telephone afterwards and asked standardised questions about the child's treatment, their progress after discharge, and overall satisfaction with the treatment.

Results—Intramuscular ketamine was administered to 100 children under 12 years of age during the study period. The drug caused no adverse events pre-operatively or intraoperatively. The main early postoperative complication was vomiting (14%). Ninety three per cent of patients were discharged the same day. No re-attendance or treatment attributable to ketamine related side effects were necessary. Over the 24 hours after discharge, vomiting occurred in 12% and ataxia in 15% of patients. Ninety nine per cent of parents were either very satisfied or satisfied with ketamine sedation and were willing for their child to receive it again, if required.

Conclusion—This study, while confirming the known safety of ketamine sedation, established its suitability for "independent" use within A&E departments by suitably qualified staff.

Keywords: ketamine; children; sedation; suturing

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