July 27, 2018

Subdissociative Dose Ketamine in the Emergency Department

July 27, 2018/ Jason Hine, MD

Emergency medicine physicians have a love affair going on with ketamine for its versatility. In this post we discuss the optimal use of subdissociative dose ketamine (SDK) for analgesia as an alternative to opioids, with our guest Sergey Motov (@painfreeED).

April 13, 2017

ACEP clinical policy - Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department

April 13, 2017/ Brooks Motley, MD

As the emergency department has increasingly become more crowded with acute psychiatric emergencies, we thought it was timely to review the ACEP clinical policy for emergency department psychiatric patients. It is hot off the press from January 2017 and updates the 2006 policy on the utility of routine labs, head imaging for new psychosis, risk-assessment tools for suicide, and use of ketamine for agitation.

March 27, 2017

Get down that K-Hole! Ketamine for Control of the Agitated Adult Emergency Department Patient

March 27, 2017/ Tammi H. Schaeffer, DO, FACEP, FACMT

Emergency physicians regularly encounter agitated patients that are a risk to both health care providers and themselves. The onset of many traditional medications is relatively slow and often requires additional doses. Although there haven’t been large numbers of studies, the use of ketamine to control the acutely agitated patient has been increasing both in the prehospital and ED settings. Its characteristics such as rapid onset, preservation of respiratory drive, and minimal hemodynamic effects make it potentially desirable as a first-dose control agent. In this post, we walk through some of the literature on the use of ketamine for the acutely agitated patient.

February 07, 2017

AAEM Clinical Practice Statement Summary- SUB DISSOCIATIVE DOSE OF KETAMINE

February 07, 2017/ Sheldon Stevenson, MD

We love ourselves some low dose ketamine for pain control. Does it work well? We think so . . but don't take our word for it. Here's our summary of the American Academy of Emergency Medicine's practice statement on it.

January 31, 2017

"It starts with a K . . . " - Low Dose Ketamine for Pain Control

January 31, 2017/ Joleen Bierlein. Pharm.D.

Pain control in the emergency department is an important part of patient care and a key reason patients seek our help. Current pharmacologic methods include opiates, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and regional anesthesia. Opiates often produce inadequate pain control in both opiate tolerant and opiate naïve patients and have adverse effects such as over-sedation, respiratory depression, nausea, hypotension, tolerance, and dependence [1]. NSAID use can be complicated by nephrotoxicity, gastropathy, and cardiac toxicity and have been implicated in 11% of adverse drug reaction related hospital admissions [2].