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I would always argue that IM ketamine is an alternative for an uncooperative child. There is likely sceaming/wrestling for the injection. A mask would help if the pt would wear one, but you should be gowned, eye protected, and masked. The same scenario would be happening with a mask induction. I guess you need to balance where you think the least struggle/contact will occur and how you can best mitigate possible spread.
Indeed a challenge!!
PS, oral ketamine may be better--need a bigger dose and longer time to work, but may be better accepted! |