Ketamine hydrochloride

Question 1

What are the Indications for use of ketamine hydrochloride?

Answer 1

• MFI (ideal drug with systolic < 90mmHg or associated bronchospasm)
• Induction of general anesthesia for short procedures not requiring skeletal muscle relaxation.
• Maintain sedation post advanced airway management
• Pain management
• Combative patients, (better in head injury patients)

Question 2

What is the dosing for ketamine hydrochloride for MFI?

Answer 2

1 - 2 mg/kg IVP (use lower doses for difficult intubation and/or in patients at risk for hypotension)

Question 3

What is the ketamine dosing for procedural sedation?

Answer 3

0.5 – 1.0mg/kg SIVP/IM; titrate to desired effect.

Question 4

What is the ketamine maintenance dosing post MFI?

Answer 4

0.5 – 1.5mg/kg SIVP q5 minutes

Question 5

What is the ketamine dosing for pain management?

Answer 5

0.2 – 0.3mg/kg SIVP/IO/IM prn q5

9-10mg/kg IN prn q5

Question 6

What is the dosing for a ketamine infusion?

Answer 6

0.5 – 1.5mg/kg/hr, start low and work your way up.

Analgesic doses are low, maintenance of sedation doses are higher. Used for transport 30+ minutes.

Question 7

What are the Relative Contraindications to the use of Ketamine Hydrochloride?

Answer 7

• Severe hypertension; Aneurysms

- Conditions where a significant elevation of BP is hazardous; acute heart failure, angina, recent MI