Ketamine: its use in the emergency department.

@article{Cromhout2003KetamineIU,
  title={Ketamine: its use in the emergency department.},
  author={Andries Cromhout},
  journal={Emergency medicine},
  year={2003},
  volume={15 2},
  pages={
          155-9
        }
}
  • A. Cromhout
  • Published 1 April 2003
  • Medicine
  • Emergency medicine
Ketamine has been known to the medical world for over 30 years, yet is not widely used to its full potential. It is often considered to be a 'third world' drug only. In light of a recent increase in interest in its use in the developed world, this review is for emergency physicians to use as a quick reference. 

Topics from this paper

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Acute pulmonary edema associated with ketamine-induced hypertension during procedural sedation in the ED.
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This is the case of a 58 yo female with a history of coronary artery disease and valve replacement who was evaluated in the ED and underwent joint arthrocentesis under conscious sedation with ketamine, leading to endotracheal intubation and cardiac arrest with successful resuscitation, stabilization and subsequent improvement.
Treatment of Status Epilepticus with Ketamine, Are we There yet?
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Ketamine: A Safe and Effective Agent for Painful Procedures in the Pediatric Burn Patient
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The development of a strict protocol ensures the safe administration of ketamine for the pediatric burn patient and establishes safe monitoring and documentation during ketamine sedation procedures.
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References

SHOWING 1-10 OF 26 REFERENCES
Use of ketamine in prolonged entrapment.
TLDR
The advantages of ketamine analgesia in the management of trapped patients after serious incidents and four case histories and a review of the literature lead to the conclusion that ketamine is the drug of choice in these situations.
Ketamine abusers presenting to the emergency department: a case series.
TLDR
Emergency physicians should include ketamine in the differential diagnosis of drug- or toxin-induced hallucinations, as well as treatment recommendations for managing the patient who presents to the ED after abusing ketamine.
The use of ketamine for the emergency intubation of patients with status asthmaticus.
We describe five patients with status asthmaticus whose respiratory acidosis persisted despite conventional treatment. Four were intubated with ketamine and succinylcholine and mechanically
Ketamine sedation for children in the emergency department.
TLDR
Ketamine is a safe and effective sedative agent for use in children requiring immobilization to enable performance of a painful procedure and is important to involve both anaesthetic staff and emergency department nursing staff in sedation protocol development to ensure a smooth introduction.
Intramuscular ketamine for pediatric sedation in the emergency department: safety profile in 1,022 cases.
TLDR
Intramuscular ketamine may be administered safely by emergency physicians to facilitate pediatric procedures in accordance with a defined protocol and with appropriate monitoring, and is highly effective, has a wide margin of safety, does not require intravenous access, and uniquely preserves protective airway reflexes.
The semantics of ketamine.
TLDR
Abstract [Green SM, Krauss B.], The semantics of ketamine: A meta-anatomy of the drug’s pharmacological properties and its role in the criminal justice system.
Ketamine Sedation for the Reduction of Children's Fractures in the Emergency Department*
TLDR
Ketamine reliably, safely, and quickly provided adequate sedation to effectively facilitate the reduction of children's fractures in the emergency department at this institution.
Sedation and analgesia for procedures in children.
TLDR
The goal of procedural sedation is the safe and effective control of pain, anxiety, and motion so as to allow a necessary procedure to be performed and to provide an appropriate degree of memory loss or decreased awareness.
Inadvertent ketamine overdose in children: clinical manifestations and outcome.
TLDR
The margin of safety in ketamine overdose may be wide, although less common and more serious outcomes cannot be excluded by this small, self-reported sample.
Intravenous ketamine sedation of pediatric patients in the emergency department.
TLDR
I.v. ketamine is a consistently effective method of producing a rapid, brief period of profound sedation and analgesia in children in the emergency department, and larger studies are needed to establish this drug's safety profile in the ED.
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