Ketamine for Pediatric Seizures

Hi everyone. I want to talk now about our EMS protocol for seizures in children and specifically the use of ketamine for refractory seizures if the child is actively seizing. Our first line of treatment is oxygen administration. We provide 15 liters per minute via non rebreather regardless of SpO2 and leave the oxygen in place throughout the post ATCL period. Actively seizing patients should receive basic BLS care followed by oxygen and a dose of rased. The dose is 0.1 mg per kg IV or IO or 0.2 mg per kg intranasal or intramuscular, with a maximal single dose of 5 mg. This can be repeated once if necessary. It's important to note that there is a contraindication for hypotension and to monitor for respiratory depression. Intranasal administration is the preferred route when vascular access is not already established. If the seizure still does not subside, we turn to ketamine. The dose is 2mg per kg intranasal or intramuscular, with a maximum single dose of 100mg. Now, as with adult patients, the entire dose should be administered regardless of whether the seizure terminates with a partial dose of ketamine. It's important to note that there are certain contraindications and precautions to keep in mind when using ketamine, such as avoiding its use in patients with penetrating eye injuries. Also, ketamine may increase schizophrenic symptoms. Just be on the lookout for that. Thank you for listening. And please remember, if you have any questions during a call, we are always just a phone call away.