The Ketamine Spectrum with Sergey Motov & Ryan Marino: Part 2 Procedural Sedation, RSI, and chemical takedowns
Apr 16, 2023
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Experts Sergey Motov & Ryan Marino discuss ketamine's diverse medical applications including procedural sedation, rapid sequence intubation, chemical takedowns. They delve into dosing strategies, combining ketamine with propofol, managing agitated delirium, and dosing considerations for chemically restraining patients.
Ketamine offers safe and effective procedural sedation with specific dosing ranges and advantages in emergency departments.
It is crucial to distinguish between intoxicated and delirious patients for appropriate sedation to avoid fatal outcomes.
Deep dives
Procedural Sedation and Ketamine Dosing Ranges
Procedural sedation using ketamine involves specific dosing ranges, skipping recreational and partially dissociative doses. The full dissociative dose can start at 1 mg per kg, but individual response variations should be noted. Ketamine offers advantages in emergency departments due to its safety profile and efficacy in managing procedural sedation for various conditions.
Best Practices for Ketamine-Based Sedation
Ketamine is especially useful in pediatric sedation due to its safety, ease of use, and quick clearance. It is preferred in scenarios where airway management is crucial, avoiding agents like propofol that may depress respiration. Ketamine's analgesic properties make it ideal in traumatic situations, shock cases, and for patients requiring sedation without compromising adrenergic drive.
Management of Agitated Delirium with Ketamine
Agitated delirium poses serious risks and requires rapid sedation for patient and staff safety. Ketamine's safety profile makes it a preferred agent for such cases, with dosing typically ranging from 3 to 5 mg per kg. It is crucial to distinguish between intoxicated and delirious patients to provide appropriate sedation while avoiding fatal outcomes due to untreated agitation, rather than the sedative itself.
Ketamine is a uniquely versatile drug. From low dose ketamine for pain control (Part 1) to procedural sedation, RSI, and chemical takedowns (this podcast, Part 2), this drug is versatile. But it needs to be used with care and attention to dosing, side effects, and adjuncts. Join us as we walk through the spectrum of use with true experts on the topic- Sergey Motov and Ryan Marino.
In Part 2 we focus on the use of Ketamine for Procedural Sedation, RSI, and the chemical takedown.