Ketamine is an illegal drug often referred to as K, Special K, vitamin K, or KitKat on the streets.
Clinics have been using ketamine to address mental health issues, including depression and PTSD.
It creates a feeling of disconnection and distorts the perception of sight and sound, similar to PCP.
Common methods of taking ketamine include:
Snorting
Oral intake
Injection
Ketamine acts relatively quickly, with effects lasting 30 to 60 minutes.
In cases of overdose:
Patients may be unconscious but do not typically exhibit decreased respiratory rates.
As of February 2011, there were reported no deaths directly linked to recreational ketamine use.
The speaker emphasizes the need to understand ketamine's medical indications and practical dosing guidelines.
For pain management, a recommended starting dose of ketamine is 0.1 to 0.3 mg/kg.
In a practical scenario for an adult with severe pain (like a broken femur), one might:
Administer 50 mg in a 100 mL bag, giving half over 15 minutes for gradual sedation.
Haldol (Haloperidol):
An antipsychotic medication used for patients who are disruptive but not dangerous.
The standard dose is 5 mg, often given with Versed (Midazolam) to enhance sedation.
Precautions include avoiding use in patients under the influence of stimulants like meth or cocaine.
Versed (Midazolam):
Used alongside Haldol to manage agitation in psychosis patients.
Dosing for adults requires adjustment based on patient response and agitation level.
Droperidol:
Another antipsychotic used for calming disruptive patients or treating nausea/vomiting and headaches.
The dosing is often half of the standard antipsychotic dose.
Potential negative effects include extrapyramidal reactions, which may require treatment with Benadryl (Diphenhydramine).
Keep an eye on QT prolongation, which could lead to dysrhythmia.
An NSAID used in pain management, especially effective for renal colic (kidney stones).
Dosage for adults is typically administered IV 15-30 mg.
Contraindications include known allergies, risk of GI bleeding, and renal failure.
Various options to manage pain include:
Fentanyl (1-2 mcg/kg)
Morphine (2-10 mg)
Ketamine (0.15-0.3 mg/kg for sedation)
Consider NSAIDs for mild to moderate pain, like Tylenol or Toradol for specific cases.
Used as a vasodilator primarily for chest pain associated with ACS or CHF.
Caution is advised in cases of inferior MI due to potential preload reduction.
When administering nitro, only give if the patient is actively experiencing chest pain with a rating above 1 on a scale of 1-10.
Monitor blood pressure and symptoms following administration.
For both droperidol and Haldol, maintain practical application in chaotic field settings.
Certain medications can be given intramuscularly through clothing when necessary, especially in emergency situations.
For ketorolac, highly effective for pain management in renal colic cases, monitor for side effects and contraindications.