Ketamine Use Part 2


Steve, Dan, and Holly bring in Dr. Ramsey Selbak to discuss Ketamine use from an ER Physician’s perspective. In addition to some case reviews, key aspects of Ketamine dosing, indications, and side effects are discussed.

Learning Points:

  • Pharmacokinetics
  • Dosing in the hospital setting
  • Preferences for Ketamine use
  • Emergence reaction
  • Patients you've seen who've used Ketamine recreationally
  • Dispelling the myth about ketamine and TBI
  • Ketamine use in sepsis, or any scenario where endogenous catecholamines have been used up
  • Unopposed alpha effects and decreasing the dosage
  • What does an adverse effect look like and what to do

Case Reviews and Themes:

  • Push dose Epi on hand as needed
  • BP neutral medication (for the most part)
  • Profound hypotension – seen in sicker patients with co-morbidities
  • Larson’s maneuver – can help break laryngospasm, give PPV to break the laryngospasm, tends to be a short-lived side effect
  • Ketamine does not cause increased ICP
  • Nystagmus is the most common and most reliable onset with kids


Content Creator: Steve Williams
CAPCE Course Number: 21-EMTP-F3-1209
Total CE Hours: 1
Level: Advanced
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.