Pre-hospital use of ketamine for analgesia and procedural sedation

Bredmose, Per P.; Lockey, David; Grier, Gareth; Watts, Bradley V.; Davies, Gareth E.

doi:10.1136/emj.2007.052753

Cited by 69 publications

(52 citation statements)

References 11 publications

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“…The mean dose of fentanyl used in our study is in line with the proposed doses in the literature [8,9,[12][13][14][15] including in the specific setting of mountain rescue [2]. The mean dose of intra-nasal fentanyl was lower than when used intravenously, which is partially explained by a significantly higher proportion of paediatric patients in the intranasal group.…”

Section: Analgesic Strategiessupporting

confidence: 84%

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pasquier¹,

Eidenbenz²,

Dami³

et al. 2017

Emerg Med

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Objective: The delivery of a safe an effective analgesia is a core principle and a priority of prehospital care. Analgesia in hostile environments (mountain settings, etc.) presents various challenges, and the benefit-risk ratio of the procedure should be evaluated. The objective of this study was to examine pain management strategies and the time spent on scene for analgesia provisions in an alpine environment. Methods:We undertook a retrospective study from a single physician-staffed helicopter emergency medical service in the Swiss Alps. Patients with isolated limb injuries were included. We examined the choice and route of analgesic medication, patient monitoring, medical co-treatments and time delays during the rescue mission.Results: Analgesia was provided to 657 (57%) of the 1156 included patients. Fentanyl was most commonly administered followed by ketamine, with or without fentanyl. Heart rhythm monitoring, oxygen administration, and saline infusion were used infrequently, but were used significantly more often in patients treated with ketamine. The median time on site was 6 minutes longer for patients receiving intravenous analgesia compared with those not receiving it.Conclusion: Analgesia in hostile environments seems to be limited to essential procedures. The safety of this approach must be confirmed.

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Section: Analgesic Strategiessupporting

confidence: 84%

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pasquier¹,

Eidenbenz²,

Dami³

et al. 2017

Emerg Med

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“…Most of the evidence addresses ketamine's administration by a variety of routes, for analgesic purposes in adults and children [28][29][30][31][32][33]. Although most studies have emanated from Europe, there are US reviews supporting ketamine use for analgesia administered by HEMS crews [34].…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting

Price¹,

Arthur²,

Brunko³

et al. 2013

The American Journal of Emergency Medicine

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“…As a result, ketamine plays an important role in procedural sedation in the emergency department (ED), including during pediatric emergencies. Its use in disaster situations and limited resources is also well documented [52] . Currently, ketamine is increasingly used in conjunction with propofol, called "ketofol", which is the mixture of ketamine and propofol in a single syringe.…”

Section: Use Outside the Operating Roommentioning

confidence: 99%

Ketamine use in current clinical practice

2016

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After nearly half a century on the market, ketamine still occupies a unique corner in the medical armamentarium of anesthesiologists or clinicians treating pain. Over the last two decades, much research has been conducted highlighting the drug's mechanisms of action, specifically those of its enantiomers. Nowadays, ketamine is also being utilized for pediatric pain control in emergency department, with its anti-hyperalgesic and anti-inflammatory effects being revealed in acute and chronic pain management. Recently, new insights have been gained on ketamine's potential anti-depressive and antisuicidal effects. This article provides an overview of the drug's pharmacokinetics and pharmacodynamics while also discussing the potential benefits and risks of ketamine administration in various clinical settings.

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Pre-hospital use of ketamine for analgesia and procedural sedation

Cited by 69 publications

References 11 publications

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Pain Management Strategies and Time Spent on Scene for Pre-Hospital Analgesia Provision in an Alpine Environment: A Retrospective Study

Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting

Ketamine use in current clinical practice

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