Ketamine and the OB patient

May 11, 2004 05:46 AM

by suzanne4

Platinum Member

Just heard a very scary story today by some of my students. At one of the major teaching facilities over here, in vaginal forceps deliveries, they are using Ketamine, no anesthesia person in the room. The dose, I think that they said 50 mg, was being administered by the nurse in the room on the order of the obstetrician. And this nurse is not trained in anesthesia. No ketamine protocol being followed.
What are your feelings on this?

athomas91 · May 11, 2004, 07:48 AM

my feelings are pity for that nurse when something goes wrong....this is where nurses need to be pro-active in patient care in not just trusting any order a doc gives just because he/she's a doc.

*suzanne4* · May 11, 2004, 08:26 AM

Unfortunately over on this side of the world, the doc is considered "G-d like" and you are supposed to do what ever they say. Definitely wouldn't be me!
But the scariest is having an OB doc order it, who has never done any anesthesia training. And this hospital actually has a training program for MDAs.
Go figure.................

*SmilingBluEyes* · May 11, 2004, 09:28 AM

Ketamine is only used by trained anethesia personnel here where I work, with damn good reason. I would NOT follow that order were I the OB nurse. But that is here where I work, where we KNOW better.

*suzanne4* · May 11, 2004, 10:08 AM

That is exactly what I told my students. You should have seen the look on my face when they were telling me about what was used. I want to be able to give them this thread and show them that it isn't only my opinion. One of my students happens to be a nurse anesthetist, but of course, at another hospital.

mother/babyRN · May 11, 2004, 10:32 AM

Cheesh...That scares the heck out of me......Good luck to you! What happens to the nurse in other parts of the world if he or she refuses to go along?

*suzanne4* · May 11, 2004, 10:36 AM

That is a big problem..................they don't refuse, and I don't think that it would be accepted. My students know that they have the right to refuse.
Hopefully I will be able to get things changed over here, but it will be slow.
V e r y S l o w ...............

mother/babyRN · May 11, 2004, 10:42 AM

Bully for you for being an advocate for things being done right for your patients...I applaud you.....Martha My dad lived over there for a year in 1969...He told us it was absolutely beautiful......I lived in Taiwan twice and hope someday to visit Thailand as well.....

alansmith52 · May 11, 2004, 04:59 PM

holy crap

I ve heard it all. did the nurse become concernded at all when the patiet stoped responding and went into a cataleptic state. if she wasn't concerned I'd say it wasn't her first time to that rodeo.

(I am speaking of course from the assumption that the nurse had no idea what she was giving)

Originally Posted by mother/babyRN

Bully for you for being an advocate for things being done right for your patients...I applaud you.....Martha My dad lived over there for a year in 1969...He told us it was absolutely beautiful......I lived in Taiwan twice and hope someday to visit Thailand as well.....

alansmith52 · May 11, 2004, 05:05 PM

hmmph

hmmmph.
next time I am coaching my wife through labor I'll have to keep this little technique in mind. maybe Ill get less mean looks.

takes the work out of coaching.

could she still say she "went natural" ??

was the patient mentally chalanged or is this standard for a forcept delivery.

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