Working in the dark: a hermeneutic inquiry into health professionals’ stories of ketamine sedation with children

Abstract

Background: Physiological risks of ketamine have been well researched, yet for health professionals (HPs) undertaking paediatric ketamine sedation, questions of benefit and harm remain. Research question: What are health care professionals’ experiences of undertaking ketamine sedation with children? Methodology: Hermeneutic narrative. Methods: The study comprised hermeneutic narrative analysis of stories from seven HPs in nursing, medicine, paramedicine, and play therapy. Findings: The theme, “seeking to control and protect” reveals the chaotic nature of paediatric emergency work and how ketamine can deliver control. The second theme “working in the dark” acknowledges that HPs try to balance perceived benefit and harm, adopting “dream-seeding” in an attempt to mitigate potentially negative psychotropic events. Conclusion: The study recommends further research into children's experiences of ketamine sedation and the use of dream-seeding to mitigate negative emergence phenomena. It also recommends education for clinicians to increase awareness of the potential for non-physiological risk and harm.

Keywords:

• ketamine
• paediatrics
• anaesthetics
• dissociative
• child
• morals
• research
• hermeneutics