New Clinical Trial in the Emergency Department takes a One-Needle Approach to Paediatric Procedural Sedation

Can children be sedated effectively with only one needle prick? This is the question posed in the latest clinical trial led by Gold Coast Health and run across several Emergency Departments in Queensland including Mackay Base Hospital and supported by MIRI.

The study known as UNIKORN will trial redUced Needles using Intramuscular Ketamine Over standaRd iNtravenous.

Children present to Emergency Departments on a daily basis with situations requiring sedation in order to conduct painful or distressing procedures.
Paediatric Emergency Medicine Specialist and Principle Investigator for the study, Dr Olwen Gilbert said while Ketamine has been a widely accepted as the preferred medication to achieve sedation in children there is still an ongoing debate on the way we administer it.

“Historically we have administered intravenous ketamine which requires a cannula to be inserted into the vein,” said Olwen.

“Cannulation is not always a straightforward procedure in children and can take multiple attempts to achieve intravenous access.

“When you add in having to restrain the child the whole experience can be distressing for both the child and the parent.”

MIRI Clinical Trials Nurse Tracy Hess and ED Nurse Educator Tori Lancini have been supporting Dr Gilbert with education sessions for ED staff with the trial commencing and recruiting its first patient last week.

Tori believes Mackay Emergency Department to be a great site to assist Gold Coast in the study.

“We have an enthusiastic group of clinicians who are really excited to be involved in this study,” she said.

“UNIKORN is aiming to recruit 537 patients over a 24 month period, it would be wonderful if Mackay could recruit a significant percentage of those patients”.

While the study primarily looks at the effectiveness of using one needle to administer intramuscular ketamine, it will also investigate differences in sedation length, length of time in the ED and number of additional needles.

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