• 
• 

Three Part Question

In [children needing painful procedures in the emergency department] is [ midazolam or ketamine] [ safer and more effective at achieving conscious sedation]?

Clinical Scenario

A mother brings her five year old son to the Emergency Department (ED) with a deep scalp laceration having fallen onto the corner of a coffee table. The wound requires sutures. For various reasons the option for procedural sedation in this department is limited to midazolam. Due to your past experience, you are more comfortable using ketamine. Although there is a large amount of data in the Emergency literature to show efficacy and safety for both agents, you are not aware of direct comparisons to back your preference for ketamine in children in the ED setting.