Episode 900: Ketamine Dosing
Emergency Medical Minute22 Apr 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

Episoder(1144)

Episode 927: Functional Gallbladder Syndrome

Episode 927: Functional Gallbladder Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Typically presents with biliary colic Right upper quadrant abdominal pain lasting more than 30 minutes and subsiding over several hours Often associate...

22 Okt 20245min

Episode 926: Supraventricular Tachycardia

Episode 926: Supraventricular Tachycardia

Contributor: Taylor Lynch MD Supraventricular tachycardias (SVTs) arise above the bundle of His The term SVT includes AV nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardi...

21 Okt 20246min

Episode 925: Table Sugar for Tongue Entrapment

Episode 925: Table Sugar for Tongue Entrapment

Contributor: Aaron Lessen, MD Educational Pearls: Pediatric case study where the child's tongue was stuck in the opening of a hard plastic drink lid Entrapment restricts circulation which causes f...

14 Okt 20241min

Episode 924: Pregnancy Cold Remedies

Episode 924: Pregnancy Cold Remedies

Contributor: Megan Hurley, MD Educational Pearls: Fevers Tylenol Up until 20 weeks NSAIDs are ok but after 20 weeks they are contraindicated Can limit the amount of amniotic fluid produced Ca...

7 Okt 20245min

Episode 923: Blunt Cerebrovascular Injury

Episode 923: Blunt Cerebrovascular Injury

Contributor: Travis Barlock MD Educational Pearls: Assessment of head and neck vascular injury due to blunt trauma Symptomatic patients require screening head and neck CT angiography EAST guid...

30 Sep 20243min

Episode 922: Chest Tube Irrigation

Episode 922: Chest Tube Irrigation

Contributor: Aaron Lessen, MD Educational Pearls: Hemothorax: blood in the pleural cavity, most commonly due to chest trauma Treatment: thoracostomy tube for blood drainage helps to avoid clott...

23 Sep 20242min

Episode 921: Pediatric Hypoglycemia

Episode 921: Pediatric Hypoglycemia

Contributor: Taylor Lynch, MD Educational Pearls: When it comes to hypoglycemia, the age dictates possible causes Neonate: Hormonal deficiency Congenital Adrenal Hyperplasia (21-hydroxylase de...

22 Sep 20244min

Laboring Under Pressure Episode 3: Hypertensive Disorders of Pregnancy with Dr. Kiersten Williams

Laboring Under Pressure Episode 3: Hypertensive Disorders of Pregnancy with Dr. Kiersten Williams

Contributor: Kiersten Williams MD, Travis Barlock MD, Jeffrey Olson MS3 Show Pearls Hypertensive disorders of pregnancy are one of the leading causes of maternal mortality worldwide. Hypertension ...

12 Sep 202428min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
jss
rekommandert
tomprat-med-gunnar-tjomlid
rss-rekommandert
forskningno
sinnsyn
villmarksliv
rss-paradigmepodden
smart-forklart
tidlose-historier
diagnose
dekodet-2
grunnstoffene
fjellsportpodden
nevropodden
noen-har-snakket-sammen
vett-og-vitenskap-med-gaute-einevoll
rss-nysgjerrige-norge