Ketamine sedation

Ketamine is an anaesthetic commonly used in emergency departments to sedate (or calm) children. This makes it easier when staff have to perform a procedure that might be painful such as stitching a wound, dressing a burn, manipulating a broken bone or removing a foreign body (such as a splinter).

Before the procedure

• Your child’s doctor will explain the details of the procedure and why sedation is required.
• It’s important to try and keep your child calm. Toys, books, music and devices can be a good distraction.
• Some local anaesthetic cream will be placed on your child’s hand or elbow to numb the area where an IV cannula (often called a ‘drip’) will be inserted into a vein. The drip will be used to give the ketamine. Occasionally it will be injected into muscle.

During the procedure

When given ketamine, your child:

• will become sleepy and not be aware of their surroundings
• will not feel pain (but they may still make noises)
• will not stop breathing (tubing may be placed in your child’s nose to help monitor their breathing)
• may twitch their arms or legs
• may drool and may need to have saliva suctioned from their mouth
• may have their eyes open (their eyes may appear to wiggle from side to side and may become watery)
• may develop a rash or vomit as a result of the ketamine.

During the procedure we will closely monitor your child’s oxygen levels, heart rate and blood pressure. Very occasionally a doctor may need to help your child with breathing during the procedure. There will be a senior doctor and nurse with your child during the sedation.

After the procedure

Your child will stay in the emergency department for one to two hours until they are back to normal, has eaten something and are back to their normal function.

Sometimes children appear to be agitated when they wake up after sedation and may experience hallucinations or disturbing dreams. These sensations improve if children are kept in a dimly lit environment and are comforted by someone they know. Feel free to cuddle your child and talk to them about how well they did and things they enjoy.

Your child will be unsteady and may seem floppy or confused for a little while. They should stay in bed until a doctor or nurse has come along to reassess them.

The cannula may be left in until your child is ready to be discharged home.

Care at home

Once you return home, your child may:

• be more sleepy than normal—it’s OK to let them sleep once you get home.
• feel nauseous (need to vomit) after the procedure—they may eat and drink but avoid big meals.
• be a bit clumsy or drowsy for the next 24 hours.  Avoid strenuous activities or things that require good coordination like bike riding, climbing and swimming.
• You should supervise your child in the bath and shower in the first 12 hours.

If you have any concerns about your child please return to the emergency department for reassessment.

Developed by the Emergency Department, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS136 Reviewed:  March 2022

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.