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Pre-hospital use of ketamine in paediatric trauma

P P Bredmose1, G Grier, G E Davies

  • 1London Helicopter Emergency Medical Service, Department of Pre-hospital Care, The Royal London Hospital, London, UK.

Acta Anaesthesiologica Scandinavica
|February 20, 2009
PubMed

Insights

Ketamine is a safe and effective option for procedural sedation and analgesia in children during pre-hospital emergency care. This review found no major side effects in pediatric patients receiving ketamine for various injuries.

Area of Science:

  • Emergency Medicine
  • Pediatric Critical Care
  • Pharmacology

Background:

  • Pre-hospital care for children requires effective analgesia and sedation.
  • Ketamine offers potential benefits for procedural sedation in pediatric emergencies.

Purpose of the Study:

  • To evaluate the use and safety of ketamine in pediatric patients by a pre-hospital physician-based service.
  • To describe ketamine administration in children under 16 years.

Main Methods:

  • Retrospective database review of 164 pediatric patients (<16 years) treated by London's Helicopter Emergency Medical Service.
  • Analysis of ketamine dosage, route of administration, co-medications, and patient characteristics.

Main Results:

  • Ketamine was administered to children with a median age of 10 years, mostly awake (GCS 15) and non-trapped.
  • Common indications included road traffic collisions, burns, and falls for procedural sedation and analgesia.
  • No significant adverse events like airway loss or oxygen desaturation were observed.

Conclusions:

  • Ketamine appears to be a safe drug for pediatric pre-hospital procedural sedation and analgesia.
  • The safety profile in this setting is reassuring, with rare use in trapped children.
  • Adequate analgesia and sedation are achievable with ketamine in pediatric emergencies.
Abstract

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