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

Avsnitt(1145)

UnfilterED #1: Dr. Michael Hunt

UnfilterED #1: Dr. Michael Hunt

On the first installment of this new series, Dr. Michael Hunt shares stories, lessons and advice as he reflects on his 35 year career as an emergency physician. Intro Music: Backbay Lounge Kevin Mac...

7 Okt 20191h

Podcast 506: Seymour Fracture

Podcast 506: Seymour Fracture

Contributor: Don Stader, MD Educational Pearls: Seymour fracture is an eponym for a Salter-Harris I/II fracture of the distal phalanx of the finger or toe in children, associated with a nailbed inur...

3 Okt 20192min

Podcast 505: Sleep on Strep Throat

Podcast 505: Sleep on Strep Throat

Contributor: Don Stader, MD Educational Pearls: Only 10% of patients receiving antibiotics for strep throat actually have the diesease Treatment of strep with antibiotics only slightly reduces the du...

1 Okt 20193min

PREVIEW: UnfilterED

PREVIEW: UnfilterED

...coming October 2019 Music: emotional by Barradeen | https://soundcloud.com/barradeen Music promoted by https://www.free-stock-music.com Creative Commons Attribution-ShareAlike 3.0 Unported https:...

28 Sep 20193min

Podcast 504: Ocular Compartment Syndrome

Podcast 504: Ocular Compartment Syndrome

Contributor: Don Stader, MD Educational Pearls: The eye is surrounded by relatively inflexible tissues such as the bone of the orbit and the fibrous tissue of the eye. This makes it relatively suscep...

26 Sep 20193min

Podcast 503: Magical Magnesium

Podcast 503: Magical Magnesium

Contributor: Dylan Luyten, MD Educational Pearls: Those that are hypokalemic are often hypomagnesemic, and should receive magnesium (Mg) supplementation if repleting potassium Mg levels are typically...

23 Sep 20198min

Podcast 502: EMS Psych Clearance

Podcast 502: EMS Psych Clearance

Contributor: Aaron Lessen, MD Educational Pearls: Patients with psychiatric complaints are often complicated to disposition from the main ED, and many will require inpatient psychiatric stays Some he...

20 Sep 20192min

Podcast # 501: Take Down Potions

Podcast # 501: Take Down Potions

Author: Jared Scott, MD Educational Pearls: Study from Hennepin County EM studied the efficacy of different drugs for agitation, which included 737 patients Most patients in this study were male and ...

16 Sep 20193min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
det-morka-psyket
kapitalet-en-podd-om-ekonomi
pojkmottagningen
sexet
rss-ufo-bortom-rimligt-tvivel
rss-vetenskapsradion-2
rss-vetenskapsradion
dumforklarat
halsorevolutionen
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
rss-experimentet
bildningspodden
vetenskapsradion
hacka-livet
intergalaktiskt