Prehospital Treatment of Benzodiazepine-Resistant Pediatric Status Epilepticus with Parenteral Ketamine: A Case Series

We report the initial six pediatric patients treated with ketamine for benzodiazepine-resistant status epilepticus in an urban, ground-based emergency medical services (EMS) system. Evidence for ketamine as a second-line agent for both adult and pediatric refractory seizure activity in the hospital setting has increased over the past decade. The availability of an inexpensive and familiar second-line prehospital anti-epileptic drug option is extremely desirable. We believe these initial data demonstrate promising seizure control effects without significant respiratory depression, indicating a potential role for ketamine in the EMS treatment of pediatric benzodiazepine-refractory seizures.

Automated summary

We present a study on six pediatric patients treated with ketamine for benzodiazepine-resistant status epilepticus in an urban emergency medical services system. Ketamine has shown efficacy as a second-line agent for refractory seizures in both adults and children, and a low-cost option for prehospital treatment is highly desirable. Initial data suggests that ketamine may provide promising seizure control effects without significant respiratory depression in pediatric patients with benzodiazepine-refractory seizures, demonstrating its potential role in EMS treatment.