THE RELATIONSHIP BETWEEN THE LACK OF AN ADEQUATE LEVEL OF SEDATION AFTER INJECTION OF KETAMINE AND THE DIAGNOSIS OF ADHD ACCORDING TO THE DSM- 5 CRITERIA INCHILDREN THAT RECEIVED PSA IN IMAM KHOMIENI HOSPITAL DURING THE YEAR 2016-2018

Background and Aim : ADHD is a neurodevelopmental disorder and the most neuroticbehavioraldisease in children and 7-9 % of children afflicated with it.Prevalence of ADHD istwice in male.Given that a significant part of ED referral patiant is pediatric patient,procedura lsedation and analgesia(PSA) is a necessary skill for emergency physician and recognize diiffre ntdrug,dosage and adverse effect of them is very important in optimal and safe sedation specially inpediatric patient.In this study we want to recognize relationship between the lack of an adequatelevel of sedation after injection of ketamine and the diagnosis of ADHD in pediatric that iscandidate for PSA in EDMethods : This was a crossectional study at ED of Imam Khomeini hospital between march 2016-2018.79 consecutive patient admitted to ED for procedural sedation.After history taking andphysical examination and ketamine injection,level of sedation evaluated by Richmond agitationscale. Emergency physician parents of the child of children diagnostic criteria for ADHD andcollected more information from medical recordResults : In a 24-month period, 79 children were interviewed that the mean age of patient was7.72 years. Of 45 patients with proper level of sedation, 4 patients had positive criteria of ADHDand 41 patients were negative. Of 31 patients with inadequate level of sedation,25 patients hadpositive criteria of ADHD and 6 patients were negativeConclusion : There was a meaningful connection in patients with ADHD according to the DSM-5 criteria and inadequate level of sedation.These group need to re-injection ketamine for optimalsedation

Keywords:

ADHD , PSA(procedural sedation and analgesia) , ketamine