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(1146)

Podcast 538: Low Maintenance Boxer's Fracture

Podcast 538: Low Maintenance Boxer's Fracture

Contributor: Jared Scott, MD Educational Pearls: A distal 5th metacarpal neck fracture is often referred to as a "boxer's fracture" and a common fracture encountered in the emergency department Splin...

4 Feb 20202min

Podcast 537: Thoughts on Cardiac Arrest

Podcast 537: Thoughts on Cardiac Arrest

Contributor:  Don Stader, MD Educational Pearls: High-quality compressions are an essential, and probably one of the most important, part of cardiac arrest  Actual evidence for drugs in cardiac arres...

3 Feb 20205min

UnfilterED #4: Dr. Vivek Tayal

UnfilterED #4: Dr. Vivek Tayal

Dr. Vivek Tayal of Carolinas Medical Center, a pioneer of using ultrasound in the emergency department, reflects on his role in establishing ultrasound use in emergency medicine and much more! Ultra...

29 Jan 202045min

Podcast 536: Epistaxis 101

Podcast 536: Epistaxis 101

Contributor:  Dylan Luyten, MD Educational Pearls: Clear the nasal passages - have the patient, if stable, blow their nose to dislodge any clot that might be in the way Searching for the source of bl...

28 Jan 20208min

Podcast 535: A Prescription for Falls

Podcast 535: A Prescription for Falls

Contributor: Aaron Lessen, MD Educational Pearls: Emergency department evaluation of falls, particularly in the elderly, should include an assessment of risk factors Common causes of falls in th...

28 Jan 20202min

Mental Health Monthly #1: Decision Making Capacity

Mental Health Monthly #1: Decision Making Capacity

In the first episode of this new series, the complexities of decision making capacity are discussed. References and Further Reading: [1] Appelbaum, P. S. (2007). Assessment of patients' competence to...

22 Jan 202010min

Podcast 534: Nerve Agents

Podcast 534: Nerve Agents

Author: Michael Hunt, MD Educational Pearls: Organophosphate "nerve agents" were developed in the 1930's These agents have cholinergic effects, which can be remembered by the mnemonic "SLUDGE" Sali...

21 Jan 20205min

Podcast 533: Hypoglycemia

Podcast 533: Hypoglycemia

Contributor: Dylan Luyten, MD Educational Pearls: Insulin related hypoglycemia can vary from a brief transient effect from short-acting forms (i.e. insulin lispro) to prolonged from long acting (i.e....

20 Jan 20204min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
nevropodden
diagnose
smart-forklart
nordnorsk-historie
abid-nadia-skyld-og-skam
rss-overskuddsliv
dekodet-2
tidlose-historier