A single intravenous dose of ketamine may rapidly reduce suicidal ideation in adults, but it has not been tested in adolescents. This pilot trial aims to determine whether studying ketamine for suicidal ideation in a pediatric emergency department is feasible. Twenty adolescents will be randomly assigned to receive either 0.5 mg/kg of intravenous ketamine or a saline placebo over 40 minutes. Suicidal ideation severity will be measured at several time points up to seven days. The main feasibility outcome is the proportion of eligible patients who complete the study protocol. The trial will also pilot three suicidal ideation severity tools and explore the intervention's efficacy, safety, and tolerability.
Children with upper respiratory infections (URIs) undergoing sedation in emergency departments (EDs) do not face a higher risk of respiratory complications or need for serious interventions compared to those without URIs. A secondary analysis of 6,292 children aged 17 years or younger who received parenteral sedation in six pediatric EDs found that the adjusted odds of any respiratory adverse event, serious adverse event, or serious intervention (such as bag-valve-mask ventilation or intubation) were not significantly elevated. The odds ratios were 1.00, 0.53, and 1.08, respectively, with confidence intervals crossing 1.0, indicating no detectable increase in risk.