Sedating for Head T
In very small babies,
I have used intranasal midazolam( 0.4-0.5 mg/kg) effectively. THe only
problem I have encountered is that it irritates the nose and the babies tend
to sneeze it out or spit it out when it hits the posterior pharynx. I am
curious as to whether inserting a wick would help . Has anyone tried this?
At times if there is an IV inplace and the child is hemodynamically
stable..IV pentothal , IV brevitol or IV pentobarbitol would be great
agents. Generally I go with the pentobarbitol either po, IM or IV , because
I am usually to busy to go to the scanner with the child ,unless the child's
condition warrants physician attendance. Pentobarbitol has such a safe TI,
that I feel OK with it being given in my absence.
SOme of my asociates have used midazolam po and have talked about ketamine
po. I haven't tried either at this time.
See the reference.
Martin Herman M.D.
1. Conners,G, Sacks WK, Leahey NF, Variations in sedating uncooperative,
stable children for post traumatic head CT. PEC,
Vol15:4, August 1999, 241-244.
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