Has anyone used/or was given Ketamine in the field as an analgesic? If so, what were your likes or dislikes.

2015-08-26T13:17:07-04:00

Response by 2d Lt Private RallyPoint Member made Aug 26 at 2015 1:20 PM

2015-08-26T13:20:14-04:00

Yes I have. Probably saved my patient.

Response by SFC Private RallyPoint Member made Aug 26 at 2015 1:21 PM

2015-08-26T13:21:16-04:00

It's a neat drug for pain control. All the benefits of morphine with limited respiratory compromise. However, it's a dissociative narcotic. Basically think of it this way, morphine dulls the pain, ketamine makes your brain forget what pain is. Downside of it is that it can cause hallucinations. So it's a bit of a trade off. My PSG ended up being given ketamine by a German doc when she broke her foot. When the 1SG and commander came to see her, she stood up and walked on it to greet them, and she didn't even realize she had pain in her foot! Crazy stuff, and I think the Army should definitely consider putting it in our toolbox for those patients that can't have morphine, or if we really need to "snowball" someone.

Response by SSG Private RallyPoint Member made Aug 26 at 2015 2:03 PM

2015-08-26T14:03:45-04:00

Not for pain control but I did for RSI. I stay away from it with pain control due to the increased blood pressure it may cause. Especially if the patient's blood pressure is already high.

Response by SGT Private RallyPoint Member made Aug 26 at 2015 2:32 PM

2015-08-26T14:32:30-04:00

There have been reports of it irritating the skin when injected IM, has anyone experienced this?

Response by SGT Private RallyPoint Member made Aug 28 at 2015 10:40 AM

2015-08-28T10:40:15-04:00

My experience with ketamine is using it to put dogs under to euthanize them and it does a heck of a good job as a sedative I've seen it take down a 150 lbs dog in less then 5 minutes

Response by SGT Hansen Paskell made Sep 1 at 2015 12:09 AM

2015-09-01T00:09:04-04:00

I like the fact that there is less cerebral aetery dilation, however some literature suggests that there is a chance of increasing ICP in closed head injuries, and I am able to use 1 drug instead of 2 (fentanyl and Ativan) to produce an amnesic state with pain control as well. Ketamine is a far more hemodynamicaly stable than morphine and fentanyl with far less chance for respiratory depression. It is great when we can make a person 'forget' why they hurt and reduce pain at the same time. I have been lobbying to get it on my civilian ambulance for over a year now..

Response by SGT(P) Crystal Marie Gray-Wallace made Sep 5 at 2015 8:34 PM

2015-09-05T20:34:59-04:00

Ketamine is amazing and there has been research done proving it also helps with PTSD. http://www.usmedicine.com/agencies/department-of-defense-dod/no-longer-just-a-horse-drug-ketamine-increasingly-used-for-military-pain-management/

http://www.ncbi.nlm.nih.gov/pubmed/18376165

No Longer Just a Horse Drug, Ketamine Increasingly Used for Military Pain Management

Annette M. Boyle ROCKVILLE, MD — Morphine has met its match — and then some. After 200 years as the gold standard in battlefield analgesia, morphine is increasingly giving way to ketamine, a phency…

Response by MAJ Private RallyPoint Member made Apr 4 at 2016 1:59 AM

2016-04-04T01:59:54-04:00

Little late answering. Ketamine is vastly underutilized by every aspect of pre-hospital medicine. Classified as a dissociative and is an NMDA antagonist. Also block opioid receptors. Study out of China in 2015 showed that ketamine also has anti-inflammatory properties. Very few side effects that require any sort of attention. 10-20% will have an emergence phenomenon, but that is mitigated with midazolam. Other S/E include vomiting-zofran, respiratory depression-only in higher doses. Pure analgesic dose: 0.1-0.25 mg/kg. Combo analgesia/sedation 0.3-0.8 mg/kg. Sedation and anesthesia: >1 mg/kg. Any doses greater than 1.5 mg/kg will not produce greater sedation, just longer duration. Steve Green out in Loma Linda, CA does a lot of good research with peds. Had one kid inadvertently given 100 times intended dose-did not have a bad outcome and no issues after. Extremely safe drug. I typically only use ketamine in the prehospital setting now.

Response by Maj Kim Patterson made Sep 3 at 2023 2:28 AM

2023-09-03T02:28:24-04:00

Although my response is several years late, I have been in a recent trial of nasal ketamine administered by professionals and monitored for 2 hours. I don’t drink, drug, smoke or gamble and had no idea what to expect. My mind was blown and it seems to be slowing my racing thoughts, PTSD, MST and depression