Tag: ketamine

Upvote Story 4
Patients with refractory status epilepticus (RSE) treated with continuous intravenous anesthetic drugs (cIVADs) may benefit from early initiation of such therapy. wWhen cIVADs are applied in RSE, prescribing them early may positively impact outcome, probably by shorter seizure duration and apparently mainly in those patients who do not have a severe RSE etiology dominating their prognosis. Fifty-three (68.8%) patients received cIVADs within the first 48... Read More | Comment
Upvote Story 6
Propofol, dexmedetomidine, and opioids are commonly used for patients requiring continuous sedation or analgesia, such as for those receiving mechanical ventilation. Although these medications are generally safe, some may be unable to tolerate them due to hemodynamic status. Ketamine is a rapid acting, dissociative anesthetic used frequently in the emergency department for sedation and, more recently, pain relief. Ketamine use during procedural sedation in the... Read More | Comment
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This book brings together an international group of clinicians and researchers from a broad swath of inter-related disciplines to offer the most up-to-date information about clinical and preclinical research into ketamine and second-generation “ketamine-like” fast-acting antidepressants. Currently available antidepressant medications act through monoaminergic systems, are ineffective for many individuals suffering from depression, and are associated with a delayed onset of peak efficacy of several months.... Read More | Comment
Upvote Story 8
Advocacy group alleges that emergency medical workers in Minnesota gave patients ketamine injections without consent, despite known risks. A consumer-advocacy group is filing a complaint with the US government about two clinical trials in Minnesota that allegedly gave agitated patients ketamine and other sedatives without their consent, despite evidence that doing so could harm their health. The trials were conducted by researchers at Hennepin County... Read More | Comment
Upvote Story 8
Thai schoolboys were rescued from the cave using dissociative ketamine plus positive-pressure facemask ventilation (to prevent water from leaking into their masks), so they basically used delayed sequence intubation strategy. The schoolboys rescued from a flooded cave system in Thailand were dosed with an anti-anxiety drug to stop them panicking during the terrifying underwater mission, the country’s prime minister has admitted. The rescue was carried... Read More | Comment
Upvote Story 4
Lidocaine has weak evidence to support its ICP blunting effects. Fentanyl may be a better choice. Ketamine is a reasonable alternative to etomidate during induction. No differnce in mortality exists between usage of succinylcholine or rocuronium. There may be a mortality difference in a subset of patients with severe head injury. More research is needed. Read More | Comment
Upvote Story 4
In terms of airway management, cricothyrotomy is one of the most advanced airway procedures an ED physician will perform. It is a last resort procedure when a patient is not able to be ventilated/oxygenated and/or intubated. Typically, this procedure requires the identification of certain landmarks such as the cricothyroid membrane, but what if you can’t identify any landmarks? What do you do? We got Rob... Read More | Comment
Upvote Story 12
Versatile and safe, Ketamine can help with sedation, induction, asthma and pain. Can a shot of it even treat suicidality? New indications for Ketamine seem to be popping up every day. Its primary ED use is for procedural sedation, though the only FDA approved use is for induction of general anesthesia. It is also used off label as a medical restraint for patients with behavioral... Read More | Comment
Upvote Story 17
After ketamine induction, high shock index patients exhibited blunted hypertensive responses and more frequent hypotension, whereas low shock index patients had sustained increases in pulse rate and SBP. One hundred twelve patients were enrolled (81 low shock index, 31 high shock index). Low shock index patients had increased SBP after induction (16 mm Hg; 95% confidence interval [CI] 11 to 21 mm Hg), whereas high... Read More | Comment
Upvote Story 20
Ketamine alters hippocampal cell proliferation after traumatic brain injury (TBI). Surprisingly, these changes were associated with improvement in a neurogenesis-related behavioral recall task, suggesting a possible benefit from ketamine administration after traumatic brain injury in mice. Future studies are needed to determine generalizability and mechanism. Traumatic brain injury was induced in mice using a controlled cortical impact injury, after which mice (N = 118) received... Read More | Comment
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THOSE who anesthetize patients with ketamine (originally given the clinical investigation number CI-581) realize it is a unique pharmacological agent. Ever since its introduction into human clinical anesthesia, ketamine has had a turbulent history. One only has to witness ketamine anesthesia emergence delirium to realize this agent produces unique psychic effects. Nevertheless, the value and safety of ketamine in the anesthetic management of a specific... Read More | Comment
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Induction doses of etomidate during rapid sequence intubation cause transient adrenal dysfunction, but its clinical significance on trauma patients is uncertain. Ketamine has emerged as an alternative for rapid sequence intubation induction. Among adult trauma patients intubated in the emergency department, we compare clinical outcomes among those induced with etomidate and ketamine. In this analysis spanning an institutional protocol switch from etomidate to ketamine as... Read More | Comment
Upvote Story 18
Ketamine use in emergency departments (EDs) for procedural sedation and analgesia is becoming increasingly common. However, few studies have examined patient factors related to adverse events associated with ketamine. This study investigated factors for consideration when using ketamine to sedate pediatric ED patients. Emergency medicine physicians should consider injection type and ketamine dose when using ketamine sedation while suturing lacerations. Read More | Comment
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Between Feb 6, 2014, and June 26, 2016, 1360 patients were assessed, and 672 were randomly assigned, with 222 in the placebo group, 227 in the 0·5 mg/kg ketamine group, and 223 in the 1·0 mg/kg ketamine group. There was no difference in delirium incidence between patients in the combined ketamine groups and the placebo group (19·45% vs 19·82%, respectively; absolute difference 0·36%, 95% CI... Read More | Comment
Upvote Story 6
To blunt postoperative pain and reduce the need for opioid drugs following surgery, anesthesiologists often give patients low doses of the drug ketamine during operations. Recent research even suggests that the drug might alleviate postsurgical delirium and confusion in older adults. But a new study led by anesthesiologists at Washington University School of Medicine in St. Louis, the University of Michigan Medical School and Weill... Read More | Comment
Upvote Story 4
Here is a crowd sourced approach that will allow most etiologies of post intubation hypotension to be identified: The AH SHITE mnemonic is something that you can quickly run through en route to the patient’s room, or at the bedside. This is intended as a starting point to the evaluation of the patient with post intubation hypotension. Anticipate that intubation can worsen underlying physiologic parameters,... Read More | Comment