In July 2019 EM :RAP chapter 3 : Pediatric Status Al Sachetti and others advocate Ketamine IV first line 1-2mg /kg after two doses of nasal midazolam not working to quiet the NMDA receptors before Keppra or Phosphenatoin. as ketamine acts faster . So they would go for ketamine IV first after maximal benzodiazepines . There is the theory oh GABA receptors diminishing and NMDA receptors increasing . NB Propofol can be extremely dangerous in children particular after "short term "according to Irene Claudius - the terrible Propofol Infusion syndrome .
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Ian L. - September 5, 2019 2:29 PM
In July 2019 EM :RAP chapter 3 : Pediatric Status Al Sachetti and others advocate Ketamine IV first line 1-2mg /kg after two doses of nasal midazolam not working to quiet the NMDA receptors before Keppra or Phosphenatoin.
as ketamine acts faster .
So they would go for ketamine IV first after maximal benzodiazepines .
There is the theory oh GABA receptors diminishing and NMDA receptors increasing .
NB Propofol can be extremely dangerous in children particular after "short term "according to Irene Claudius - the terrible Propofol Infusion syndrome .