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The College of Emergency Guidelines on the use of Ketamine quotes a
dose of 2.5 mg / kg im not 2 mg/ kg. We introduced low dose ketamine at
Lancaster in the Emergency Depertment in the early 1990's and we have had
no critical incidents in this department. The College also highlights a
recent paper by Green.
"A recent meta-analysis showed that low IM doses of ketamine (<3.0
mg/kg) exhibited significantly less overall airway and respiratory adverse
events. There were
no occurrences of either laryngospasm or apnoea in the 682 children
receiving lower IM doses 1 "
Top up doses may be needed though this is in a minority of cases for
simple wound suturing.
1. Green S, Roback M, Krauss B, Brown L, McGlone R, et al. Predictors
of Airway and Respiratory
Adverse Events of Ketamine Sedation in the Emergency Department: An
Data Meta-Analysis of 8,282 Children. Accepted Dec 2008 Ann Emerg Med.
No competing interests
30 November 2009
Consultant in Emergency Medicine
Royal Lancaster Infirmary, Ashton Rd, Lancaster LA1 4RP