Ketamine

[BAYAMedic]

Ok so here I am echoing Croakers post from last month. Due to the drug shortages, we are unable to get Etomidate and are switching to Ketamine. What can you guys tell me about your experiences with Ketamine for sedation for RSI.

Fireman1037

[Kiwiology]

Ketamine is a wonderful anaesthetic drug, it has excellent cardiovascular stability and can be used in low dosages for analgesia as well as in large doses for anaesthesia

It is a bit weird in that the patient is unconscious but their eyes will probably still be open and they may salivate a bit

[BAYAMedic]

Thanks kiwi,

Our dosing is 2mg/kg and may be repeated to maintain sedation. So would this be a better adjunct to use than midazolam for cardioversion or pacing?

Fireman1037

[Kiwiology]

2mg/kg is an anaesthetic dose

You can use that dose for cardioversion yes but it will render the patient unconscious

[chbare]

Have had good experiences. Ketamine is interesting and is known as a dissociative anaesthetic agent. You may have a patient appear to be awake, but their conscious mind has been completely separated from their body. Additionally, ketamine also has analgesic properties.

[DFIB]

Can you titrate for effect? Begin the push until their eyes fix?

[Kiwiology]

Yes that's perfectly acceptable with either small fixed bolus amounts (10-20mg) or say .05mg/kg

[DFIB]

Yes that's perfectly acceptable with either small fixed bolus amounts (10-20mg) or say .05mg/kg

Gracias

[Vorenus]

Ketamine is a wonderful anaesthetic drug, it has excellent cardiovascular stability and can be used in low dosages for analgesia as well as in large doses for anaesthesia

It is a bit weird in that the patient is unconscious but their eyes will probably still be open and they may salivate a bit

You`ll find a nystagmus, too.

We`ve used Ketamine, Esketamine, Ketamine and then Esketamine again (medical director is a bit undecided obviously ).

Good stuff.

Be sure to keep within the boundaries of the purpose you want to acchieve (analgesic vs. anaesthetic) and remember using a benzo to keep away the funny dreams.

Edited March 1, 2012 by Vorenus

[Doczilla]

Ketamine is probably better than versed for cardioversion or pacing because of minimal effects on BP or HR. Since any patient you are cardioverting in the field is likely unstable or hypotensive, ketamine makes more sense than a drug that will drop BP.

'

(null)