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)

Episode 958: Intranasal Fentanyl

Episode 958: Intranasal Fentanyl

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medi...

26 Touko 20251min

Episode 957: Cardiac Asthma

Episode 957: Cardiac Asthma

Contributor: Travis Barlock, MD Educational Pearls: Wheezing is classically heard in asthma and COPD, but it can be the result of a wide range of processes that cause airflow limitation Narrowed bro...

19 Touko 20253min

Episode 956: Psychedelics and Risk of Schizophrenia

Episode 956: Psychedelics and Risk of Schizophrenia

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Psychedelics are being studied for their therapeutic effects in mental illnesses, including major depressive disorder, post-traumatic str...

12 Touko 20252min

Episode 955: Cardiac Effects of COVID-19

Episode 955: Cardiac Effects of COVID-19

Contributor: Ricky Dhaliwal, MD Educational Pearls: What factors are considered in a COVID-19 infection? The viral load: Understood as the impact of SARS-CoV-2 viral particles infecting host cell tis...

5 Touko 20254min

Episode 954: Combo Rescue Inhalers - New Guidelines

Episode 954: Combo Rescue Inhalers - New Guidelines

Contributor: Aaron Lessen, MD Educational Pearls: What is a Rescue Inhaler? A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack.  Historical...

30 Huhti 20253min

Episode 953: Penicillin Allergies

Episode 953: Penicillin Allergies

Contributor: Geoff Hogan MD Educational Pearls: Penicillin allergies are relatively uncommon despite their frequent reports 10% of the population reports a penicillin allergy but only 5% of these...

21 Huhti 20252min

Episode 952: Heart Transplants

Episode 952: Heart Transplants

Contributor: Travis Barlock, MD Educational Pearls: Key clinical considerations when managing heart transplant patients due to their unique pathophysiology 1. Arrhythmias A transplanted heart i...

14 Huhti 20253min

Episode 951: Pediatric Febrile Seizures

Episode 951: Pediatric Febrile Seizures

Contributor: Taylor Lynch, MD Educational Pearls: Pediatric febrile seizures are defined as seizures that occur between the ages of six months to five years in the presence of a fever greater than o...

7 Huhti 20256min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
tiedekulma-podcast
rss-lihavuudesta-podcast
utelias-mieli
docemilia
mielipaivakirja
radio-antro
rss-opeklubi
sotataidon-ytimessa
hippokrateen-vastaanotolla
rss-laakaripodi
rss-mental-race
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi