How do intranasal ketamine and fentanyl compare for children with painful limb injuries? This appraisal examines a small randomised trial reporting similar pain relief but more minor adverse events with ketamine, alongside concerns about sample size, trial design and applicability across different clinical settings.
JC: IN Fentanyl vs Ketamine for analgesia in PED. St Emlyn’s Read More
Can virtual reality make venepuncture and cannulation less painful for children? Natalie May appraises a 2019 randomised study, examining pain scores, differences between clinical settings and feedback from children and carers, while considering the limits and practicalities of this distraction technique.
JC: Virtual Reality for Distraction from Paediatric Procedural Pain Read More
Should adults receive midazolam or haloperidol before ketamine sedation in the ED? This 2019 trial appraisal weighs reduced agitation against longer recovery, examines the study’s size and outcome measures, and asks whether observed behaviour captures what matters to patients.
JC: Should we premedicate for ketamine sedation? St Emlyn’s Read More
Intranasal ketamine or fentanyl for children with painful fractures? This 2018 appraisal compares pain relief and reported side effects in a small randomised trial. It explains why similar pain scores do not prove equivalence, and why the selected patient group limits how widely the results can be applied.
JC: Intranasal Ketamine vs. Fentanyl for kids. St. Emlyn’s Read More
Natalie May continues her reflections on a year with Sydney HEMS, focusing on paediatric retrieval, drowning and airway care. These personal clinical lessons explore equipment, communication and the compromises involved in delivering critical care outside the hospital.
101 Reflective Lessons from a Year with Sydney HEMS. Part Four: More Clinical Read More
Whose assessment counts when a child is in pain? This 2017 appraisal of paediatric pain scales examines agreement between children, nurses and doctors, questioning whether disagreement justifies dismissing children’s reports and what a single pain measurement can really tell us.
JC: Pain Scales in the Paediatric ED Read More
Small changes can make an emergency department visit feel less frightening for a child. Inspired by ICEM 2016, this reflection explores welcoming children, involving caregivers, using play, listening carefully and respecting dignity, with children’s rights at the centre of the encounter.
Making ED Visits Easier for Children Read More
Natalie May’s 2015 EuSEM teaching notes explore why treating children’s pain involves more than choosing a drug. The discussion brings together analgesia, preparation for procedures, communication, parental support and distraction, with particular attention to the fear and distress surrounding an emergency department visit.
Paediatric Pain and Sedation – Tips to Change Your Practice from #EuSEM15 Read More
