Is intranasal ketamine as a sole agent a safe and effective form of sedation in children for short procedures within the emergency department?

Report By: Dr H Chatha - CT1 - ACCS
Search checked by Dr Sa Narang - Consultant in Paediatric Emergency Medicine
Institution: Whiston Hosiptal
Date Submitted: 22nd August 2010
Last Modified: 22nd August 2010
Status: Blue (submitted but not checked)

Three Part Question

Is [intranasal ketamine] as a sole agent a safe and effective form of [sedation] in [children] for short procedures within the emergency department?

Clinical Scenario

A 5 year old boy is brought to the emergency department following riding his bike into a lamp-post. On examination he is noted to have a large laceration across his forehead that unfortunately needs suturing. The young boy is petrified by needles and will not allow you to place a cannula or give an IM injection. The question is asked whether intranasal ketamine is a safe and effective alternative for sedation in this patient.

Search Strategy

Using medline via OVID interface the following search strategy: 1950 - June Week 5 2010
[Sedation .mp. or Anesthetics, Dissociative or Conscious Sedation] and [Intransal Ketamine.mp. or (Intranasal and ketamine)] and [children.mp. Pediatrics/ or Child/ or Child, Preschool/ or paediatrics.mp. or Infant]