Ketamine

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Section 8 - MEDICATION GUIDELINES

ANESTHETICS

Ketamine / Anesthetic

DESCRIPTION

  • Dissociative anesthetic, Systemic. Schedule III controlled substance.

INDICATIONS

  • Sedation in the extremely agitated patient
  • Musculoskeletal Pain / Extremity Pain
  • Combative Post Resuscitation

CONTRAINDICATIONS

  • Hypersensitivity
  • Penetrating eye injury.
  • Pregnancy
  • Due to sympathomimetic effects, contraindicated in patients with known, severe CAD (for example, patients currently experiencing STEMI).

PRECAUTIONS

  • Have ventilatory support readily available
  • There is no known antidote or reversal agent for Ketamine
  • Emergence Reaction - Read "Special Note" at RxList - Ketamine


DOSAGE

  • Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.

Onset of action:

  • IM administration: 3 – 5 minutes
  • IV administration: 1- 2 minutes

Duration of action:

  • 20 – 40 minutes when dosed at 4mg/kg IM.
  • 12 – 20 minutes when dosed at 2mg/kg IV.

Side Effects:

  • Hypertension, emesis, laryngospasm, tachycardia, bronchodilation, increased salivation, emergence reaction (12%).