PACU nurse give Ketamine?

[kathy3kat]

Are PACU nurses allowed to give lower dose Ketamine for pain? We recently had an Anesthesiologist get angry because a RN in PACU would not give ketamine for pain. I can not find any state board regulations or guidelines. Anyone kmow?

[GHGoonette, BSN, RN]

I'm not crazy on ketamine; it's very good for pain control, and I know a lot of anaesthetists who use it, both to give bolus doses and in PCA pumps, and it's very effective. If it's prescribed, there's no reason why an RN can't give it. The problem I have with the stuff is the hallucinatory effect it has. It can cause some very nasty trips indeed. From that point of view, I would request the anaesthetist to prescribe an alternative analgesic.

[ChristineN, BSN, RN]

I've given Ketamine on the acute care floor (low-dose, not sedation). If it can be done there I don't see the problem with a PACU nurse giving it.

[Charity, RN, APRN]

Until this month, we (PACU nurses) thought we could not give Ketamine as it is classed as an anesthetic. The hospital just okayed Ketamine in PCA pumps, to be ordered by our Pain Service only. So I suppose we can, in low doses. I suppose it is similar to our epidural policies. We can't give the test dose, but can initiate the infusion later.

[PACURN1818]

We have 2 anesthesiologists in particular that are fond of ketamine if nothing else is working and the patient is kinda going nuts. I have had several people react well, and several have what they would describe as a "bad trip" It has, howver seemed to break the cycle and help every time. We tend to give 10 to 20 mg ivp times 1

[meandragonbrett]

Look up your hospital policies. We can't possibly tell you the answer to this. In my facility, there are not any meds that we cannot/ do not give.

[Isabelle49]

Each state BON would have to rule on whether an RN can administer Ketamine, since it is an anesthetic. I would be very careful about what your hospital says you can give. They are not always on point with the laws and often try to placate the physicians. Puts the nurse on the line!