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Ketamine sedation — RACP Paediatrics MCQ

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EasyEmergencyKetamine sedationRACP Paediatrics

A 4-year-old requires procedural sedation for reduction of a displaced distal radius fracture in the ED. The child is fasted, haemodynamically stable, and otherwise well. The ED team has appropriate monitoring and resuscitation equipment. What is the most commonly used agent for brief painful procedures in Australian paediatric EDs?

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Correct answer: A — Ketamine IV

IV ketamine is the most commonly used agent for brief painful procedures in Australian paediatric EDs. It provides dissociative sedation with analgesia and amnesia while maintaining airway reflexes and cardiovascular stability. Standard dose is 1-1.5 mg/kg IV. Side effects include emergence reactions (reduced with concurrent midazolam), hypersalivation, and rare laryngospasm.

Reference: RCH Melbourne – 2023 – Procedural Sedation CPG; RACP Paediatric Curriculum – Emergency