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To reduce the need for intravenous sedation, a pediatric emergency department began using intranasal (IN) ketamine in patients aged ≥6 months. Researchers prospectively surveyed 52 clinicians about their experience giving IN ketamine for procedures during a 5-month period.
Among 196 patients (median age, 3.8 years), IN ketamine doses ranged from 2 to 5 mg/kg (median, 4 mg/kg) and the most common procedures were laceration repair (43%) and orthopedic procedures (16%). Overall, 6% of patients had adverse events (nausea, dizziness, drowsiness), but no patients needed intubation or respiratory support. Fifteen patients (8%) had treatment failures and needed full sedation to complete procedures; 40% of treatment failures were in patients undergoi…