Podcast 811: Ketamine for Pain

Podcast 811: Ketamine for Pain

Contributor: Lessen, Aaron MD

Educational Pearls:

  • Ketamine can be given at 0.2-0.3 mg/kg as subdissociative doses for pain control in the ED
    • Ketamine coadministered with Haldol may reduce agitation
  • A recent study in Iran compared subdissociative Ketamine given with 2.5 mg Haldol to 1 mg/kg Fentanyl for pain control in the ED
    • Ketamine with Haldol had better pain control than Fentanyl at 5, 10, 15 and 30 minutes
    • Ketamine with Haldol less frequently required rescue medication
    • Ketamine with Haldol did have increased agitation at only the 10 minute mark
    • Of note, there was not a Ketamine only group to compare
  • Ketamine with Haldol is a viable alternative combination for pain control

References

Moradi MM, Moradi MM, Safaie A, Baratloo A, Payandemehr P. Sub dissociative dose of ketamine with haloperidol versus fentanyl on pain reduction in patients with acute pain in the emergency department; a randomized clinical trial. Am J Emerg Med. 2022;54:165-171. doi:10.1016/j.ajem.2022.02.012

Sin B, Ternas T, Motov SM. The use of subdissociative-dose ketamine for acute pain in the emergency department. Acad Emerg Med. 2015;22(3):251-257. doi:10.1111/acem.12604

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

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Podcast 861: Alcohol Withdrawal and Delirium Tremens

Podcast 861: Alcohol Withdrawal and Delirium Tremens

Contributor: Travis Barlock MD Educational Pearls: Alcohol binds the GABA receptor, which produces an inhibitory response, hence the "depressive" effects of ethanol beverages. Over time, alcohol d...

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Ukraine Brewtalk Featuring Dr. Dave Young

Contributors: David Young MD, John Hesling MD, Travis Barlock MD, Jeffrey Olson Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss several clips from the even...

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Podcast 860: Thyrotoxicosis

Podcast 860: Thyrotoxicosis

Contributor: Travis Barlock MD Educational Pearls: Clinical picture: A patient comes in with altered mental status, tachycardia, fever, elevated T4, and low TSH. What's the diagnosis?... Thyrotoxicosi...

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Podcast 859: Teamwork Really Makes the Dream Work

Podcast 859: Teamwork Really Makes the Dream Work

Contributor: Aaron Lessen MD Educational Pearls: 33 Medical residents and 91 nurses at Massachusetts General Hospital were randomized into two groups: Intervention group: 15 PGY-1 residents assig...

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Podcast 858: Whole Blood Pregnancy Test

Podcast 858: Whole Blood Pregnancy Test

Contributor: Meghan Hurley MD Educational Pearls: What do you do if you need a stat pregnancy test on an incapacitated patient? You can send a serum quantitative human chorionic gonadotropin (beta-H...

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Podcast 857: Alice in Wonderland Jeopardy

Podcast 857: Alice in Wonderland Jeopardy

Contributor: Chris Holmes MD Educational Pearls: "It's a poor sort of memory that only works backwards" - Transient Global Amnesia A syndrome with sudden retrograde memory loss in which patients ...

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Podcast 856: ED Errors and Counterstudy

Podcast 856: ED Errors and Counterstudy

Contributor: Nicholas Tsipis, MD Educational Pearls: What study was Dr. Tsipis talking about? In December of 2022, the Agency for Healthcare Research and Quality (AHRQ) put out a study titled "Diagn...

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Podcast 855: QT Intervals

Podcast 855: QT Intervals

​​Contributor: Travis Barlock MD Educational Pearls The QT interval represents phases 2 and 3 of ventricular plateau and repolarization, respectively. As the QT interval lengthens, more sodium an...

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