Smith J A, Santer L J
Department of Emergency Medicine, North Carolina Baptist Hospital, Winston-Salem.
Ann Emerg Med. 1993 Mar;22(3):613-5. doi: 10.1016/s0196-0644(05)81956-0.
A healthy 4-year-old boy presented to the pediatric emergency department after inserting a black-eyed pea into his right external ear canal. Initial attempts at removal of this foreign body were unsuccessful, resulting in patient agitation. After administration of intramuscular ketamine for sedation, the patient was observed to experience one ineffective respiration followed by a period of apnea. No excessive oropharyngeal secretions or laryngospasm were noted. Spontaneous respirations resumed after 40 seconds, and the child recovered with no apparent ill effects. This case illustrates the need for adequate monitoring and preparation for emergency airway management when using ketamine for sedation in the ED.
一名健康的4岁男孩将一颗黑眼豆塞入右外耳道后被送往儿科急诊科。最初尝试取出这个异物未成功，导致患儿躁动。在肌内注射氯胺酮进行镇静后，观察到患儿出现一次无效呼吸，随后出现一段时间的呼吸暂停。未发现口咽分泌物过多或喉痉挛。40秒后自主呼吸恢复，患儿康复且无明显不良影响。该病例表明，在急诊科使用氯胺酮进行镇静时，需要进行充分的监测并做好紧急气道管理的准备。
