Pakistan floods: innovations and guidance for the response.

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Adequate pain control through sedation and anesthesia for emergency procedures is a crucial aspect of pediatric emergency care. Resources for administering such anesthesia are extremely limited in many low-income settings.

In this study, ninety procedures were completed for 77 pediatric patients utilising the ESM-Ketamine package.  There were no serious adverse events in any of the cases and only 17 % experienced minor adverse events.  All surveyed providers reported they would use the ESM-Ketamine package again in similar cases.

The paper concludes that ESM-Ketamine package, through the use of a simplified protocol and checklist, allows for safe analgesia and anesthesia in children by non-anesthetists in a resource-limited setting for selected emergent and urgent procedures. It summarises that this package addresses a significant gap in the availability of anesthesia services in low-income settings that would otherwise result in significant delays to procedures or proceeding with painful procedures with inadequate analgesia.

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