In this pilot study, sedation for endoscopy with ketamine and midazolam was as effective as conventional sedation, as acceptable to patients, and was not associated with dysphoric events. Ketamine may have potential as an agent for sedation in higher risk patients.

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Heparin-induced thrombocytopenia is known to produce thrombotic events in addition to bleeding. A large external haematoma developed around the radial arterial line site in a patient with proven HIT while receiving lepirudin. The haematoma masqueraded as continued bleeding and delayed starting renal replacement therapy. This case emphasised the importance of close visual examination of intravascular catheter sites for any evidence of thrombosis.