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It is indeed a risk/benefit issue. 
In an extremely agitated well-appeared neonate with 'difficult IV', my next step is intranasal Midazolam. Works great (0.3 mg/kg), haven't had any major side effect so far.
Itai


-----Original Message-----
From: Gary Joubert [mailto:[log in to unmask]]
Sent: Monday, January 19, 2009 09:22 AM
To: [log in to unmask]
Subject: Re: ketamine for septic w/u

Agree, is a bit extreme to me as well. Need to consider risk benefit to child, I think little benefit and lots of risk. GJ >>> 2009/01/18 9:01 PM >>> seems quite extreme to me... TZ In a message dated 1/18/2009 7:11:46 P.M. Central Standard Time, [log in to unmask] writes: Do any of you sedate kids to get a septic wu done? I had a 4 week old (today he was 4weeks) with fever of 38.6 who looked quite good , feeding bottle avidly, had hx cough and was rsv neg. no one could get iv (nicu nurses tried eight times) and i could not get lp due to xs squirming. It would seem to be so much easier for me and prob for kid to give i m ketamine, get a line (groin if needed or ej) and do the lp on a stationary target. Whaddya think? whaddya do? would everyone have done a complete work up? we got cbc,crp and ua/cxr which were normal and the cx was pending of course. don For more information, send mail to [log in to unmask] with the message: info PED-EM-L The URL for the PED-EM-L Web Page is: http://listserv.brown.edu/ped-em-l.html **************A Good Credit Score is 700 or Above. See yours in just 2 easy steps! (http://pr.atwola.com/promoclk/100000075x1215855013x1201028747/aol?redir=http://www.freecreditreport.com/pm/default.aspx?sc=668072%26hmpgID=62%26bcd=De cemailfooterNO62) For more information, send mail to [log in to unmask] with the message: info PED-EM-L The URL for the PED-EM-L Web Page is: http://listserv.brown.edu/ped-em-l.html -------------------------------------------------------------------------------- This information is directed in confidence solely to the person named above and may contain confidential and/or privileged material. This information may not otherwise be distributed, copied or disclosed. If you have received this e-mail in error, please notify the sender immediately via a return e-mail and destroy original message. Thank you for your cooperation. For more information, send mail to [log in to unmask] with the message: info PED-EM-L The URL for the PED-EM-L Web Page is: http://listserv.brown.edu/ped-em-l.html 

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