Intramuscular ketamine to facilitate pediatric central vascular access

Area of Science:

• Pediatric Emergency Medicine
• Anesthesiology
• Vascular Access

Background:

• Obtaining prompt vascular access in pediatric patients in the emergency department (ED) is crucial but challenging.
• Difficult vascular access necessitates timely interventions, especially for critically ill children.

Purpose of the Study:

• To evaluate the efficacy of intramuscular (IM) ketamine in facilitating central venous catheter (CVC) placement in pediatric ED patients.
• To describe the experience and outcomes of using IM ketamine for CVC insertion in children.

Main Methods:

• Retrospective medical record review of pediatric patients (<18 years) undergoing CVC placement facilitated by IM ketamine.
• Study period: May 1998 to August 2003 at a tertiary care pediatric ED.

Main Results:

• Eleven pediatric patients met inclusion criteria, aged 6 months to 8 years.
• All patients were medically complex and required timely vascular access.
• Central venous access was successfully obtained in all subjects; vomiting was the sole complication.

Conclusions:

• Intramuscular ketamine is a helpful adjunct for emergency physicians to achieve central venous access in pediatric patients.
• Familiarity with IM ketamine for this indication can improve patient care in the ED.