Freezing patients

I have now had enough experiences with small children and objects stuck in noses to know that Ketamine is a gift from God. Awhile back I watched someone struggle for 30 min. against a 5 year old with the help of the child's father and a surgery tech., but with no success in removing the object. We came back after a break, gave him ketamine in his IV, he froze in sleep, and we had the object out in less than a minute.

Last week another small child came in with something reportedly stuck in his nose. He thrashed and screamed as the nurse injected ketamine into his IV. A few minutes later the object was removed without difficulty, and he was waking up peacefully on the bed.

This man had a posterior dislocation of his 5th MCP joint - the knuckle where the finger meets the hand. It needed to be put back into place, but this would cause severe pain if he was awake.



This picture was taken just after ketamine was given in his IV, and shows how patients tend to "freeze" in whatever position they receive the medication. While he slept we put the finger back into place and applied a splint. Oh, and he also woke up singing.