The Use of Ketamine Sedation for the Treatment of Nail Bed Repairs in the Pediatric Emergency Department

Abstract

This study aimed to determine if sedation with ketamine is safe and effective for the treatment of nail bed injuries in the pediatric emergency department (PED).Method: A retrospective cohort study was carried out during a 9-month period in children aged between 18months and 15years, presenting to PED requiring nail bed repair. We documented complications of sedation, clinical outcome of the repair both immediate and at follow-up, and parental satisfaction at 4 months. A cost analysis was also undertaken.Results: Ten repairs were performed. There were no serious adverse events. The average satisfaction score was 9.4/10. All patients were discharged from follow-up by 3months. There was a cost saving of approximately £1500 per case. Conclusions:We have demonstrated nail bed injury repair facilitated by sedation with ketamine to be safe, effective, and cost efficient in the PED. This management strategy, brought to the fore during the COVID-19 pandemic, should be adopted widely in PEDs.