2015 Trumbull Memorial Hospital Demo

Ketamine (Ketalar) Ketamine (Ketalar ® )

Action

Onset

Dissociative anesthetic Stimulates opioid receptors

IV 1 minute IM 4-5 minutes

Indications Pain Control (Adult and Ped) Painful Procedures / Extrication Excited Delirium RSI

Adult Dose Pain Control: 0.1-0.2 mg/kg IVP/IO/IM, Maximum 20mg Painful Procedures/Extrication: 0.4 mg/kg IVP/IO/IM, Maximum 40mg Excited Delirium: 5 mg/kg IM or 2 mg/kg IVP/IO if the line is already established RSI: 2 mg/kg IVP/IO

Pediatric Dose Pain Control: 0.2 mg/kg IVP/IO or 0.3mg/kg Nebulized or 2 mg/kg MAD

Contraindications Hypersensitivity to the drug, schizophrenia, children < 2 months old.

Adverse Reactions Cardiovascular: BP and pulse rate are frequently elevated following administration. Hypotension and bradycardia have been observed, and arrhythmia has also occurred. Gastrointestinal: Nausea, vomiting, increased salivation. Neurological: Enhanced musculoskeletal tone may be manifested by tonic and clonic movements sometimes resembling seizures. Nystagmus is common. Respiratory: Although respiration is frequently stimulated, severe depression of the respiration or apnea may occur following rapid IV administration of high doses. Laryngospasms and other forms of airway obstruction have occurred, but can be managed via BVM. Precautions Resuscitative equipment should be ready for use. IV dose should be administered over 1 minute. More rapid administration may result in respiratory depression or apnea and enhanced pressor response. Use caution in chronic alcoholics and the acutely alcohol-intoxicated patient.

Considerations Monitor vital signs frequently. Use caution with elderly and pediatric patients.

207

EMR

EMT

AEMT

Paramedic

Extended