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Ketamine: A Safe and Effective Agent for Painful Procedures in the Pediatric Burn Patient

Owens, Victoria F. FNP; Palmieri, Tina L. MD; Comroe, Catherine M. PNP; Conroy, Janice M. RN; Scavone, John A. MD; Greenhalgh, David G. MD

doi: 10.1097/01.BCR.0000204310.67594.A1
Original Articles

Ketamine is an effective agent when used for sedation during painful bedside procedures. We developed a ketamine administration protocol for nonanesthesiologists for the purpose of establishing safe monitoring and documentation during ketamine sedation procedures. From June 1, 2002, through June 30, 2003, a total of 522 sedation events using ketamine were performed; 347 of these events were analyzed. Seventeen (4.9%) events contained potentially adverse outcome indicators, 10 (2.9%) of which required intervention. Eight events were airway related and responded to repositioning, supplemental oxygen, or bag-valve-mask ventilation. Two patients had a decrease in blood pressure, which responded to fluid administration. Total doses of ketamine administered were between 6 and 800 mg, for procedures ranging from 1 to 105 minutes, in patients weighing between 3 and 111 kg. The development of a strict protocol ensures the safe administration of ketamine for the pediatric burn patient.

From Shriners Hospital for Children, Northern California Sacramento, California.

Address correspondence to Victoria Owens, Shriners Hospital for Children, Northern California 2425 Stockton Boulevard, Sacramento, California 95817.

© 2006 The American Burn Association