Article Text

Download PDFPDF
Ketamine is not a safe, effective, and appropriate technique for emergency department paediatric procedural sedation
  1. N S Morton
  1. Correspondence to:
 N S Morton
 Department of Paediatric Anaesthesia, Intensive Care and Pain Management, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK;

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Definitive studies are needed

In the United Kingdom, there is very little formal competency based training in the techniques of paediatric procedural sedation except in the specialty of dentistry.1,2 Procedural sedation is often delegated to junior medical staff using a local protocol. The procedures for informed consent, documentation, monitoring, recovery, follow up, and audit are varied and often non-existent. This situation is changing as new clinical governance and training systems are put in place. In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) has produced a multidisciplinary, evidence based, peer reviewed guideline for the management of paediatric procedural sedation.3 The consensus view of this group was that, in Scotland, ketamine (and agents such as propofol, fentanyl, alfentanil, and remifentanil) should only be used by those trained in and with adequate on-going experience of paediatric anaesthesia and/or intensive care. It should only be used in a hospital …

View Full Text


  • The author is Chairman of the SIGN Develop-ment Group for SIGN Guideline 58

Linked Articles

  • Primary Survey
    Roderick Mackenzie