Episode 900: Ketamine Dosing
Emergency Medical Minute22 Huhti 2024

Episode 900: Ketamine Dosing

Contributor: Travis Barlock MD

Educational Pearls:

Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3.

Pain dose

  • For acute pain relief administer 0.3 mg/kg of ketamine IV over 10-20 minutes (max of 30 mg).

  • Note: There is evidence that a lower dose of 0.1-0.15 mg/kg can be just as effective.

Dissociative dose

  • To use ketamine as an induction agent for intubation or for procedural sedation administer 1 mg/kg IV over 1-2 minutes.

IM for acute agitation

  • If a patient is out of control and a danger to themselves or others, administer 3 mg/kg intramuscularly (max 500 mg).

  • If you are giving IM ketamine it has to be in the concentrated 100 mg/ml vial.

Additional pearls

  • Pushing ketamine too quickly can cause laryngospasm.

  • Between .3 and 1 mg/kg is known as the recreational dose. You want to avoid this range because this is where ketamine starts to pick up its dissociative effects and can cause unpleasant and intense hallucinations. This is colloquially known as being in the "k-hole".

References

  1. Gao, M., Rejaei, D., & Liu, H. (2016). Ketamine use in current clinical practice. Acta pharmacologica Sinica, 37(7), 865–872. https://doi.org/10.1038/aps.2016.5

  2. Lin, J., Figuerado, Y., Montgomery, A., Lee, J., Cannis, M., Norton, V. C., Calvo, R., & Sikand, H. (2021). Efficacy of ketamine for initial control of acute agitation in the emergency department: A randomized study. The American journal of emergency medicine, 44, 306–311. https://doi.org/10.1016/j.ajem.2020.04.013

  3. Stirling, J., & McCoy, L. (2010). Quantifying the psychological effects of ketamine: from euphoria to the k-Hole. Substance use & misuse, 45(14), 2428–2443. https://doi.org/10.3109/10826081003793912

Summarized by Jeffrey Olson MS2 | Edited by Jorge Chalit, OMS II

Jaksot(1144)

Podcast 787: TAVR and Stroke

Podcast 787: TAVR and Stroke

Contributor: Nick Hatch, MD Educational Pearls: Transcatheter aortic valve replacement (TAVR) is an increasingly common endovascular procedure to treat aortic stenosis TAVR is an alternative to the o...

6 Kesä 20224min

Podcast 786: Smiling Death

Podcast 786: Smiling Death

Contributor: Nick Hatch, MD Educational Pearls: "Smiling Death" describes the prehospital phenomenon of a person who is happy to be extricated from an extended period of crush injury, but dies sudden...

31 Touko 20226min

Podcast 785: Pepper Spray

Podcast 785: Pepper Spray

Contributor: Jared Scott, MD Educational Pearls: Pepper spray is a chemical irritant derived from oleoresin capsicum (OC), an extract from pepper plants. It can be used by police for riot or crowd co...

30 Touko 20226min

Podcast 784: Wastewater Surveillance for COVID

Podcast 784: Wastewater Surveillance for COVID

Contributor: Jared Scott, MD Educational Pearls: About 50% of those infected with SARS-CoV-2 will shed the virus in their feces Wastewater surveillance can be used to track COVID burden, which may ...

24 Touko 20225min

Podcast 783: LAD Occlusion & Troponin

Podcast 783: LAD Occlusion & Troponin

Contributor: Jared Scott, MD Educational Pearls: A study randomized 34 healthy patient to have their left anterior descending artery (LAD) occluded by balloon for 0, 15, 30, or 90 seconds Subsequen...

23 Touko 20225min

Podcast 782: Ventilator Management

Podcast 782: Ventilator Management

Contributor: Aaron Lessen, MD Educational Pearls: Tidal volume is the amount of breath a patient receives in a single ventilation Traditional tidal volume (TV) setting was 10 ml/kg but studies showe...

17 Touko 20223min

Podcast 781: Foxglove, Dropsy, and Salvador Dali

Podcast 781: Foxglove, Dropsy, and Salvador Dali

Contributor: Chris Holmes, MD Educational Pearls: Foxglove plant contains the cardiac glycoside digoxin Foxglove leaf potions were once used to treat Dropsy; a historic term for symptoms of heart f...

16 Touko 20224min

Podcast 780: Pediatric Sedation Post-Intubation

Podcast 780: Pediatric Sedation Post-Intubation

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looking at a pediatric emergency department to determine what percentage of patients after intubation received sedation within 10 minute...

10 Touko 20223min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
tiedekulma-podcast
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-laakaripodi
rss-lihavuudesta-podcast
rss-sosiopodi
ihanat-ipanat
sotataidon-ytimessa
mielipaivakirja
rss-radplus
rss-opeklubi