Ketamine is extensively used in emergency medicine and, in fact, is the “go to” medication for procedural sedation in kids. It is routinely used in ER’s across America every day in young children who require sedation for painful procedures such as facial lacerations and reduction of broken bones. We have a number of patients with mental health conditions and chronic pain who are teenagers. That being said when we consider infusion therapy for patients under the age of 18 we require approval of and close cooperation with, the patient’s primary care and mental health provider.