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Special K – ketamine is making a comeback – new, safer and smoother!

Ketamine for ED sedation – seems to be making a big comeback for pretty much anything you want it for.

Check out the link below to a great review of recent study and the ED Updates guide to its use.  It has also been championed by Dr Weingart at EmCrit for use in “delayed sequence intubation” where you use K to sedate the patient to get the oxygen into them pre RSI!

http://emupdates.com/2011/01/27/taming-the-ketamine-tiger/

What about using ketamine in the head-injured trauma patient.  We see a lot of this in Broome and the traditional anaesthetic teaching is that “ketamine raises intracranial pressure” and therefore a no-no, but is this true?  It is a great agent for sedation / intubation induction in the sick trauma patient, so can we use it in head-injured punters?  Well the Canadian Journal of EM has released a review article that looks at all the old studies and some recent work that suggests that ketamine is not really such a bad thing for your cerebral perfusion, maybe even a bit neuroprotective.  In Australia we don’t have access to the alternatives – etomitade, Precedex, etc  so I think ketamine might be a good option.  Check out the link below and drop me your opinion…

http://www.cjem-online.ca/v12/n2/p154

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