Ketamine

Question 1

Clinical condition or situation to which this PGD applies

Answer 1

Severe pain following traumatic injuries

Procedural sedation to facilitate patient safety, extrication and management including the movements of patients to a healthcare facility

Question 2

Inclusion criteria

Answer 2

Analgesia for severe pain associated with traumatic injuries

Procedural sedation to facilitate patient safety, extrication and management including the movement of patients to a healthcare facility

Orthopaedic manipulations - adults and children

Question 3

Exclusion criteria

Answer 3

Persons in whom an elevation of blood pressure would constitute a serious hazard

Eclampsia or pre-eclampsia

severe coronary or myocardial disease

known or suspected schizophrenia

patients who are physically entrapped or a location which prevents immediate management of the airway

Question 4

Cautions

Answer 4

severe hypertension

ocular injuries

thyroid disorders - risk of tachycardia / hypertension

pregnancy

Question 5

Name, form and strength of medication

Answer 5

Ketamine hydrochloride 10mg per ml

Ketamine hydrochloride 50mg per ml

Question 6

Dose and frequency

Answer 6

Analgesia 0.1mg per kg up to 0.5mg per kg

Sedation 0.25mg per kg up to 0.5mg per kg

In rare occasions dose up to 1mg per kg may be used in young and fit adults

IM route: 4 - 5mg per kg using 50mg per ml concentration.

IN route: 1 - 1.5mg per kg using 50mg per ml concentration.

TCC should be consulted for use of the 50mg per ml solution.

Question 7

Common adverse effects

Answer 7

Increased HR

Agitation, confusion, hallucination, and abnormal behaviour

Nystagmus, tonic / clonic movements, diplopia hypertonia