Procedural Sedation Is Safe for Children Younger Than 2 Years

About 6% of children who were sedated with combinations of ketamine, morphine, and midazolam experienced adverse events, all of which were minor, except for one case of respiratory failure.

Several studies have shown that emergency physicians can safely administer procedural sedation to children. However, little research has focused on emergency department sedation of children younger than 2 years. Researchers retrospectively reviewed charts of all cases of procedural sedation in children younger than 2 years at a single U.S. children’s hospital ED during a 30-month period. Of 180 eligible patients, 173 (96%) were included in the analysis (73% were aged 1–2 years). The study hospital was a high-volume level I trauma center; physicians’ credentials were not reported.

Medications included various combinations of midazolam, ketamine, and morphine; most patients (62%) received ketamine plus midazolam. Ten patients (5.8%) experience…

Reviewing Author

Daniel J. Pallin, MD, MPH