Sedating unfasted children may be dangerous

We are concerned by some of the guidance offered in Atkinson and colleagues’ clinical review of pain management and sedation for children in the emergency department—specifically, the use of intravenous anaesthetic induction agents ketamine (and propofol and midazolam) by “appropriately trained” doctors in doses (2 mg/kg for ketamine) sufficient to induce general anaesthesia in unfasted children.1 Healthcare …