Ketamine
Section 8 - MEDICATION GUIDELINES
ANESTHETICS
Ketamine / Anesthetic
DESCRIPTION
- Dissociative anesthetic, Systemic. Schedule III controlled substance.
INDICATIONS
- Sedation in the extremely agitated patient
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
- If this occurs give Benzodiazepine.
- DIAZEPAM (VALIUM) 2 - 20 mg SLOW IVP or IM to desired effect.
- MIDAZOLAM (VERSED) 2 - 10 mg IV, IO or IN, titrated to effect.
- If this occurs give Benzodiazepine.
DOSAGE
- Dose is 2 mg/kg SLOW IVP OR 4 mg/kg IM, 1 dose
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%).