Atropine has been shown to reduce hypersalivation as well as
nausea and vomiting induced by ketamine sedation.
Atropine can increase the occurrence of a transient rash, as
well as tachycardia.
There are no guidelines that recommend for or against atropine
use in pediatric patients undergoing ketamine induced
Ultimately, it is the providers decision to include atropine
when performing ketamine sedation.
Pediatric dosing for atropine is 0.01mg/kg IM.
Heinz P, Geelhoed GC, Wee C, Pascoe EM. Is atropine needed with
ketamine sedation? A prospective, randomised, double blind study.
Emerg Med J. 2006 Mar;23(3):206-9. doi: 10.1136/emj.2005.028969.
PMID: 16498158; PMCID: PMC2464444.
Chong JH, Chew SP, Ang AS. Is prophylactic atropine necessary
during ketamine sedation in children? J Paediatr Child Health. 2013
Apr;49(4):309-12. doi: 10.1111/jpc.12149. Epub 2013 Mar 15. PMID:
Shi J, Li A, Wei Z, Liu Y, Xing C, Shi H, Ding H, Pan D, Ning
G, Feng S. Ketamine versus ketamine pluses atropine for pediatric
sedation: A meta-analysis. Am J Emerg Med. 2018
Jul;36(7):1280-1286. doi: 10.1016/j.ajem.2018.04.010. Epub 2018 Apr
5. PMID: 29656945.
Presented and Summarized by Devan Naughton, 4th year
pharmacy student | Edited by Ruben Marrero-Vasquez
About the Podcast
Emergency Medical Minute is medicine's most prolific podcast. Geared towards physicians, nurses and paramedics! Tune in weekly for real, raw and relevant medical education.