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)

Podcast 889: Blood Pressure Cuff Size

Podcast 889: Blood Pressure Cuff Size

Contributor: Aaron Lessen MD Educational Pearls: Does the size of a blood pressure (BP) cuff matter? A recent randomized crossover trial revealed that, indeed, cuff size can affect blood pressure read...

5 Feb 20241min

Podcast 888: Low GCS and Intubation

Podcast 888: Low GCS and Intubation

Contributor: Aaron Lessen MD Educational Pearls: Is the adage, "GCS of 8, you've got to intubate" accurate? A recent study published in the November 2023 issue of JAMA attempted to answer this questio...

29 Jan 20242min

Podcast 887: Family Presence in Cardiac Resuscitation

Podcast 887: Family Presence in Cardiac Resuscitation

Contributor: Aaron Lessen MD Educational Pearls: A 2013 study randomized families of those in cardiac arrest into two groups: Actively offered patients' families the opportunity to observe CPR ...

22 Jan 20242min

Podcast 886: Cough in Kids

Podcast 886: Cough in Kids

Contributor: Ricky Dhaliwal, MD Educational Pearls: Croup Caused by: Parainfluenza, Adenovirus, RSV, Enterovirus (big right now) Age range: 6 months to 3 years Symptoms: Barky cough ...

15 Jan 20246min

Podcast 885: Penetrating Neck Injuries

Podcast 885: Penetrating Neck Injuries

Contributor: Ricky Dhaliwal MD Educational Pearls: Three zones of the neck with different structures and risks for injuries: Zone 1 is the most caudal region from the clavicle to the cricoid cart...

10 Jan 20244min

Laboring Under Pressure Episode 2: Postpartum Hemorrhage with Dr. Kiersten Williams

Laboring Under Pressure Episode 2: Postpartum Hemorrhage with Dr. Kiersten Williams

Contributor: Kiersten Williams MD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss a clip from Dr. Williams' talk at t...

8 Jan 202425min

Podcast 884: Nerve Blocks

Podcast 884: Nerve Blocks

Contributor: Meghan Hurley MD Educational Pearls: What is a nerve block? A nerve block is the medical procedure of injecting anesthetic into the area around a nerve to block pain signals. They ar...

1 Jan 20246min

Podcast 883: Migraine Treatment in Cardiovascular Disease

Podcast 883: Migraine Treatment in Cardiovascular Disease

Contributor: Jorge Chalit, OMS II Educational Pearls: Migraine pathophysiology Primarily mediated through the trigeminovascular system Serotonin, dopamine, and calcitonin gene-related peptide (...

25 Des 20233min

Populært innen Vitenskap

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