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intranasal versed actually is even easier. you can also use ketamine intranasal. a lot of the trauma of procedural sedation for kids is the IV start or IM injection. this avoids both.

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I prefer ketamine IM. The kids never remember the injection. I've used intranasal versed and have had mixed results, some it works great, other kids I get no sedation at all. The IV form orally sounds promising though, probably better absorption and less variability than I've seen intranasally

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It has been years but we used to mix Versed into orange juice - very very little juice and 0.25 to 1 mg/kg with max 20 mg - and have peds fracture patients drink it.

They get dopey.

We can put in an IV without any drama and keep them on oxygen.

Reduce fracture with C-arm - apply splint.

Allow to wake up slowly. Reverse with Romazicon if needed.

Kids wake up amnestic with a splint and no idea how it got there. They are fascinated by the splint on their arm and are cute and amusing.

 

The pharmacy started making us Versed lollipops to avoid ingesting liquids in case we had to go to the OR.

A nice grape lollipop and watch the kid get super dopey and fade out. 

 

I haven't done it in years. But, it was quite successful.

 

Years ago we used pedi-cocktails - Demerol-Phenergan-Thorazine - WOW, drunk kids. I learned to hate sending them home with parents when they were SOOOO stoned and pitiful. I wasn't a parent then and didn't realize how scary it was for them. Sometimes the cocktail was the only way to sew up facial wounds or complex wound debridement, etc. 

 

I would gladly use a Versed Lollipop now. Some days - I would want one............................... oops - outside voice.

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Versed lollies would be good - I remember the days of Fentanyl freezies and we still have the lozenges in the Canadian Forces.  If we could do that with ketamine I'd be happy - my fav with kidlets.  Of course, I guess there is the problem of control of the freezer...

 

SK

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oh boy

 

I can see it now

 

someone decides to write for PO as an outpatient and the patient takes all of it with in  one day....  "I couldn't remember if I took any of it?"

 

 

 

 

 

 

 

 

 

 

 

 

 

 

sorry could not resist that one....

as a father of 3 yr old who frequents the ER (ugh) doing this before a lab draw would be GREAT

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