IM Ketamine policy

[Guest219794]

Has anybody got a written policy on IM administration of Ketamine for peds?

This is within the scope of practice of nurses in my state.

We periodically do it, but have no written policy.

I am hoping we can adopt a policy, and would love to review other policies.

[canoehead, BSN, RN]

Ketamine is considered a procedural sedation, and falls under that policy for me.

[hella_RN]

I have never given IM Ketamine but I have given it IV. Adverse effects include hypotension and respiratory depression so I personally would ask the provider if he/she would like it to be IV so that we have IV access just in case the patient become hypotensive and has resp distress. Just my 2 cents!

[hella_RN]

At OP, I will have to look at my hospital's policy for this and hopefully can have an answer for you

[MunoRN, RN]

We use a separate dissociative sedation policy, since the effects of ketamine are much different than CNS depressants. Ketamine isn't generally considered to be a cause of respiratory depression or circulatory depression, but it can cause hypersalivation and emergence reaction, so our policy includes atropine for hypersalivation, and versed for emergence reaction. Our post procedure monitoring time is also shorter with ketamine.

[Anna Flaxis, BSN, RN]

At my current facility, procedural sedations on kids under 12 are done by anesthesia, but where I worked previously, we did lots of IM Ketamine on kiddos, for one thing because one IM injection was faster and less traumatic to a kiddo than an IV insertion, and Ketamine is NOT associated with respiratory depression or hemodynamic instability. It's actually pretty darn safe, and we didn't have an RT present too manage the airway in these cases.

We treated IM Ketamine the same as any procedural sedation, with the exception of having an RT present, and so we didn't have a separate policy.