Ketamine

Question 1

Presentation

Answer 1

200mg in 2 mL glass ampoule

Question 2

Contraindications

Answer 2

Suspected non-traumatic brain injury with sever hypertension (SBP > 180)

Question 3

Precautions

Answer 3

may exacerbate cardiovascular conditions (e.g. uncontrolled hypertension, stroke, recent MI, cardiac failure) due to effects on HR and BP

Question 4

Indications

Answer 4

Intubation
Analgesia
Sedation
-agitation
-patient movement during CPR

Question 5

Onset

Answer 5

IV
30 seconds, anaesthesia
Duration: 5-10 minutes
IM
3-4 minutes
Duration: 12-25 minutes
IN
5 minutes
Peak - 20 minutes
Duration: 45 mintues

Question 6

Dosage IN

Answer 6

IN
(ADD 0.1ml for dead space in the MAD)
75mg repeat 50mg at 20 minute intervals, no max dose
OR
50mg for (,60kg/frail/elderly)
Repeat 25mg at 20 minute intervals
no max dose

Question 7

Dosage IV

Answer 7

Dilute 200mg in 2mL to 20mL with 18 mL normal saline = 10mg/mL
Administer over 1 minute

Analgesic dose - consult only
10-20mg at 5-10 minute intervals

Procedural dose
20-30mg at 2 minute intervals until patient is dissociated or analgesia is adequate

Infusion
Ketamine infusion
0.1-0.3 mg/kg/hr