notoriousBSN

I do think there's a very specific age range where cold spray "works", but you're right, it's usually more of a placebo effect more than anything, in the same way that putting a bandaid on an "ouchie" can make everything better, even a fever haha. I'm definitely more in the "hold the limb down with the strength of Zeus and four other nurses to just get it over with" camp myself.

What are the CRNA's thoughts on ketamine's potential sympathomimetic qualities and the idea that it may deplete catecholamine stores in critically-ill peds patients, thereby decreasing blood pressure and cardiac output? Anecdotally, I've seen ketamine given for pain control or sedation during rapid responses (that had been called way later than they should have been), and the kiddo promptly coding on us. Maybe I'm just paranoid but the risks associated with ketamine seem pretty serious compared to a topical EMLA cream or a cold spray.

1) for quick down & dirty critical care concepts- Life In the Fast Lane's Critical Care Compendium has great overviews, just take it with a grain of salt b/c it is adult focused 2) for peds specific critical care- ditto on the Mary Fran Hazinski book 3) if you can get your hands on a pediatric CCRN review book (not just a question book), reviewing it alongside your clinical cases can actually do wonders for your understanding even if you're not planning on taking the CCRN any time soon.