Ketamine Hydrochloride

5.21 Ketamine Hydrochloride
 
 

ACTIONS
Nonbarbiturate anesthetic.

INDICATIONS

  • Violent Agitated Patient
  • Failure to “talk patient down”
  • Suspected “Excited Delirium” ( confusion, agitation, drug abuse)
  • Resisting restraints putting self or crew in danger

CONTRAINDICATIONS

  • Significant Head Trauma
  • Increased intracranial pressure

WARNINGS/PRECAUTIONS
Respiratory depression/apnea may occur with overdosage or too rapid rate of use; employ supportive ventilation and respiration. Caution with chronic alcoholics and acutely alcoholintoxicated and in elderly patients. Use in pregnancy is not recommended.

ADVERSE REACTIONS

  • Hypertension and tachycardia, generally self limited
  • Laryngospasm: may produce mild stridor, oxygen and BVM prn
  • Hypersalivation
  • Nausea and vomiting
  • Tonic and clonic muscle movements
  • Transient respiratory depression occasionally occurs
  • Roving eye movements and nystagmus

PSYCHOLOGICAL ADVERSE REACTIONS

  • Visual Hallucinations
  • Emergence Delirium
  • Sensation of detachment from the body

ADULT DOSAGE IM or IN is the preferred route
4 mg/kg IM (max dose 400 mg) to the lateral thigh or deltoid
2 mg/kg IN
1 mg/kg IV

If safe to do so consider temporarily releasing the patient after injection till sedation occurs (2 or 3 minutes)