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I don't know if this has alreay been brought up on the list but I was
wondering what the group's practice habit is regarding the addition of
Versed to IM/IV ketamine to reduce the incidence of dysphoric emergence
reactions.  I always add atropine or glyccopyrolate but don't always add
Versed as some sources I've read recommend - I do use it when sedating
older kids due to the higher risk of dysphoria.
Also I recently had a unusual failure of ketamine (admittedly I slightly
underdosed using only 3mg/kg IM) and wasn't able to find a reference as
to the safety of multiple doses (more than two)of ketamine for the same
procedure or what the maximum mg/kg dose is.


Elliot Rodriguez, MD FACEP
SUNY HSC Syracuse

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