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Ketamine is unique among sedatives in that it does not cause respiratory depression. Serious adverse events are rare. Ketamine is used widely in resource-poor environments, but systematic studies of its safety in this setting are lacking. These authors reviewed a quality-assurance database from a rural Ugandan hospital to identify all cases of nurse-administered ketamine sedation during a 4-month period. The nurses underwent a brief training program in ketamine sedation.
Nurses administered ketamine sedation without physician supervision for 191 procedures in 118 patients. Procedures included abscess drainage (36%), orthopedic procedures (20%), and burn care (18%). Half the patients were younger than 18 years and 18% were younger than 2 year…