The Role of Ketamine as an Adjuvant Therapy for Children With Acute Status Asthmaticus

Inclusion Criteria: * Pediatric patients (≥2 years and ≤ 18 years old) Patients presenting in status asthmaticus: * Patients with a CAS of greater than or equal to 10 on presentation that have received at least two (appropriately dosed based on weight) albuterol treatments prior to arrival OR * Patients with a CAS of greater than or equal to 10 that have not received treatment prior to arrival and after 1 hour of treatment per the severe asthma pathway do not have a decrease in CAS of greater than 2 OR * Patients with a CAS above 6 but less than 10 as measured 1 hour after initiation of standard treatment per AU's moderate asthma pathway Exclusion Criteria: * Pregnancy * Congestive Heart Failure or prior diagnosis of cardiovascular disease (congenital or acquired) * Chronic lung disease outside of a previous diagnosis of Asthma * Seizure disorder * Liver disease * History of hypertension greater than 95% for age * Obstructive Sleep Apnea with AHI greater than 5 * History of allergic or serious reaction to Ketamine * Significant history of psychiatric illness defined as any patient with a diagnosis of psychiatric illness meeting the Diagnostic and Statistical Manual of Mental Disorders V criteria (severe Autism)