[eph432girl]

http://allnurses.com/forums/showthread.php?t=75929

This post talks about a rural hospital that used Ketamine on a child and they encountered some trouble. I want your opinions - was this they right choice or too risky? What would have been a better alternative? Any other helpful/insightful thoughts.


This is really weird, because I had a dream that my 6 yr old little girl broke her arm and I wanted the ER docs to use Ket to sedate her before they set her arm. HOWEVER, in my dream, I MADE ER call CRNA to be in the room in case my little one had respiratory problems... the er doc was laughing at me, but I did not care and said that I want the experts in the room in case he encountered a diffucult airway.... am I the only one who has crazy dreams like this?


ok, so let me know what you guys think. Teach me!!!!
Christine

[athomas91]

Christine - the posts that follow the OP had some very good helpful hints and advice on dosing etc...

first of all - using ketamine w/o versed is evil
everything has its place - versed, morphine, etomidate etc...can all go bad very quickly...

with the training/education i have gained (i have always been an ER nurse)
i wouldn't personally use any general anesthetic in the ER - if the doc is gung-ho - let them push it..... IMHO

[sjt9721]

IM Ketamine is the only ketamine you'll see in our ED. IV Ketamine must be administered by a CRNA or anesthesiologist since it is an anesthetic agent.

I was amazed at how quickly it takes effect. It worked great for the little one who had the hook of a clothes hanger lodged in her palate!

[Tia]

Originally Posted by sjt9721

IM Ketamine is the only ketamine you'll see in our ED. IV Ketamine must be administered by a CRNA or anesthesiologist since it is an anesthetic agent.

I was amazed at how quickly it takes effect. It worked great for the little one who had the hook of a clothes hanger lodged in her palate!

I use to think that it was ok for Ketamine/conscious sedation drugs to be used in the ER by certified RN's because I was one of those people. Despite me being prepared for problems that could arise there is always that chance..but that was never going to happen to me Now that I am an SRNA I am starting to learn some of the side effects that I couldn't have handled. Now I am NOT saying that it can't be done because like I said before I have been there but they should be used very carefully.

Tia

[Qwiigley]

Ketamine must be administered WITH Versed. Doesn't matter how young the child is. Doses work quick and the patient continues to breath by themselves. Beware of ICP side effects. IOP side effects. Great for active wheezing asthmatics. Safe when used by CRNAs or anesthesiologists; not others. Too many SE they are not familiar with. (IV)
Chlorohydrate works great in the ED, CT or MRI for kids.

[gaspassah]

anyone using methohexital rectal anymore?
d

[eph432girl]

Originally Posted by gaspassah

anyone using methohexital rectal anymore?
d

gas,
if you have time to type, would you mind telling me more about this?

[gaspassah]

methohexital was once used as a premed for peds pts. it's a barbituate that you can give rectally as a suppository *i think*. anyhoo, it was supposed to produce profound sedation in kids. it's old old school i think, i was just wondering if anyone was using it, or felt there was still a market for it.
d

[jwk]

Originally Posted by gaspassah

methohexital was once used as a premed for peds pts. it's a barbituate that you can give rectally as a suppository *i think*. anyhoo, it was supposed to produce profound sedation in kids. it's old old school i think, i was just wondering if anyone was using it, or felt there was still a market for it.
d

It was actually given in liquid form - I couldn't tell you the last time I've seen or heard of it - probably more than 20 years ago.