Re:Ketamine that's injected during arrests draws new scrutiny
by wittyreference on Sunday August 23, 2020 @09:49AM
(#24251932)
I’m pretty sure the lit goes up to 8 mg/kg for IM. In the case of a 100lb pt, that’s what, 50kg? So they give the pt 6 mg per kg. It’s not out of the range of sanity, all else equal.
Key point though: you wouldn’t give the pt 8 mg/kg in a fucking bolus. Time to onset for sedative effect is fast (10min or so); time to peripheral adverse effects can easily take an hour. You’d start way lower than 8, and work your way up if you needed to.
Re:Ketamine that's injected during arrests draws new scrutiny
by rscho on Sunday August 23, 2020 @09:55AM
(#24251973)
> So they give the pt 6 mg per kg. It’s not out of the range of sanity, all else equal.
Well yeah, but as I understand it the goal is not to intubate in this case, right? So in my opinion, 6 is already way too much.
In fact, I don't think we can agree on a safe standard dose in this case. Which suggests that it's not the right choice of drug for that use case...
Iv dose for induction of general anesthesia is ~3-5 mg/kg. Or ~5 mg/kg intramuscularly.
The main thing with ketamine is that it causes tachycardia/arrhythmias and increases blood pressure. While that can be desirable for people in shock, it is a big problem if the person is already under proarrhythmic drugs (e.g. cocaine).
In Europe, we use antipsychotics for similar situations (haloperidol).