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Paediatrics
Paediatric IV ketamine sedation very safe
Systematic Review of Pediatric Ketamine in Emergency Department Procedural Sedation: Frequency and Predictors of Adverse Events
Annals of Emergency Medicine · Added 19 September 2026
Systematic review of 20 studies covering 67,871 children having IV ketamine procedural sedation in EDs — no deaths or permanent adverse outcomes, sentinel events pooled at about 1 in 11,558 sedations, serious adverse events 0.34%, with age ≥10, upper respiratory infection and opioid co-administration modest predictors while ASA status and benzodiazepine co-administration were not.
- Study type
- Systematic review
- Design
- Systematic review of studies with ≥250 children
- Participants
- 58,752 children receiving IV ketamine in EDs across 20 studies
- Main finding
- No deaths or permanent adverse outcomes; pooled sentinel events 0.0041% (~1 in 24,390 sedations); serious adverse events 0.33%; predictors of serious events were age ≥10 years, upper respiratory infection and co-administered opioids.
- Caveat
- Heterogeneity across studies; ED (not prehospital) setting; rare-event estimates imprecise.
- Bottom line
- Supports current practice
Why it matters in Australia (Medium relevance). ED-based procedural sedation rather than prehospital practice, but reassuring safety data for a heavily used AP formulary drug
Learning goal
Strengthen my risk assessment for paediatric ketamine sedation by recognising which children face higher adverse event risk.
More
- Topic: Paediatrics
- Daily scan: 19 September 2026
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