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(1146)

Podcast 569: The eFAST Exam

Podcast 569: The eFAST Exam

Contributor: Aaron Lessen, MD Educational Pearls:.   Focused assessment with Sonography for Trauma (FAST) exam and the extended-FAST (eFAST) are essential components of current trauma care and evalua...

8 Kesä 20202min

Podcast 568: Shock 'em!

Podcast 568: Shock 'em!

Contributor: John Winkler, MD Educational Pearls: Unstable ventricular tachycardia (VT) typically manifests with syncope, shortness of breath, diaphoresis and/or chest pain with hemodynamic instabili...

2 Kesä 20203min

Podcast 567: Mechanical CPR….Not So Fast

Podcast 567: Mechanical CPR….Not So Fast

Contributor: Aaron Lessen, MD Educational Pearls: Mechanical CPR (machine assisted compression devices) remains a hot topic of debate in emergency medicine Machine assisted CPR has been advocated to ...

1 Kesä 20202min

Selected Audio from 'UnfilterED #7: Russell J. Ledet, Ph.D.'

Selected Audio from 'UnfilterED #7: Russell J. Ledet, Ph.D.'

"Go unafraid! And also know that you got to reach out to the right people and hold on to those people no matter what they look like, no matter what background they come from...Find people who are posi...

31 Touko 20205min

UnfilterED #7: Russell J. Ledet, Ph.D.

UnfilterED #7: Russell J. Ledet, Ph.D.

Russell J. Ledet hails from Lake Charles, Louisiana. After serving in the U.S. Navy, he attended Southern University and A&M College for his undergraduate degrees in biology and chemistry. Afterwards,...

27 Touko 202058min

Podcast 566: The Cholera Pandemic

Podcast 566: The Cholera Pandemic

Contributor: Jared Scott, MD Educational Pearls: Cholera has been responsible for 6 previous global pandemics and currently the world is in the seventh pandemic of cholera, ongoing since 1961. Choler...

26 Touko 20204min

Podcast 565: Cesarean Scar Pregnancies

Podcast 565: Cesarean Scar Pregnancies

Contributor: Nick Hatch, MD Educational Pearls: A cesarean scar ectopic pregnancy occurs when the pregnancy implants along the scar tissue deep in the myometrium from a prior cesarean surgery, felt t...

25 Touko 20203min

COVID-19 Digest: The Possible Link Between Severe COVID-19 and Low Vitamin D Levels (Recorded 5/21/20)

COVID-19 Digest: The Possible Link Between Severe COVID-19 and Low Vitamin D Levels (Recorded 5/21/20)

Host: Elizabeth Esty, MD. At this point, with so many of the studies we've digested exploring correlations, associations, observational studies and anecdotal reports and speculation, we could subtitle...

22 Touko 202018min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
utelias-mieli
rss-astetta-parempi-elama-podcast
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-sosiopodi