Ketamine

Question 1

Ketamine
Type

Answer 1

Anaesthetic agent

Question 2

Ketamine
Presentation

Answer 2

200mg in 2ml vial

Question 3

Ketamine
Actions

Answer 3

1. Analgesia; sedative agent
2. Amnesic properties
3. Has bronchodilator properties
4. does not tend to cause respiratory depression
5. Does not tend to cause hypotension (via sympathetic stimulation), unless catecholamine depleted (eg shock)
   Onset of action is rapid IV=1-2mins IM=3-5mins

Question 4

Ketamine
Use (AP)

Answer 4

Initial pharmacological intervention for combative/agitated patients, who are an immediate danger to themselves or others

Question 5

Ketamine
Adverse Effects

Answer 5

LHHERM
1. Laryngospasm
2. Hypersalivation
3. Hypotension if given too rapidly to a hypovolaemic patient
4. Emergence reactions
5. Respiratory depression - apnoea
6. Muscle twitching and purposeless movements

Question 6

Ketamine
Contraindications

Answer 6

KAC or CAK
1. Known hypersensitivity
2. Active cardiac disease (MI, LVF, uncontrolled hypertension)
3. Children <1 year old

Question 7

Ketamine
Precaution

Answer 7

Shocked patients
When using ketamine for any indication in a shocked. Catecholamine-depleted patients, consider a smaller dose that the full weight based dose and be mindful that onset of action will be prolonged.

Question 8

Ketamine
Notes

Answer 8

1. Patients may still have significant awareness despite an appearance of unconsciousness. They may be able to hear and have some recall. Patients should be advised they will experience strange/unusual sensations.
2. ICP back up should be called for all patients sedated with Ketamine

Question 9

Ketamine
Dose (AP)

Answer 9

Adult only
200mg IM injection. Reduce dose to 100mg with age >65years or with general debility

Repeat: 1mg/kg IM injection (after 5 mins if required)