Nebulized Ketamine?

The EMS Lighthouse Project

Description:

Let’s say you were looking for a safe and effective BLS option for analgesia. Something other than oral acetaminophen or ibuprofen. You want the Green Whistle (methoxyflourane) but you can’t get the Green Whistle (thanks FDA!). How about sub-dissociative ketamine by nebulizer? Sounds great, but you’re worried about your colleagues getting stoned, aren’t you? Admit it, you are. Fortunately, there are breath actuated nebulizers. Maybe those things will work?

Dr Jarvis reviews a recent paper that compares the effectiveness of nebulized ketamine compared with IV ketamine. And he gives a quick review of some other papers that paved the way for this one.

Citations:

1. Nguyen T, Mai M, Choudhary A, Gitelman S, Drapkin J, Likourezos A, Kabariti S, Hossain R, Kun K, Gohel A, et al.: Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of Emergency Medicine. (2024) May 2.

2. Motov S, Mai M, Pushkar I, Likourezos A, Drapkin J, Yasavolian M, Brady J, Homel P, Fromm C: A prospective randomized, double-dummy trial comparing IV push low dose ketamine to short infusion of low dose ketamine for treatment of pain in the ED. Am J Emerg Med. 2017;August;35(8):1095–100.

3. Motov S, Rockoff B, Cohen V, Pushkar I, Likourezos A, McKay C, Soleyman-Zomalan E, Homel P, Terentiev V, Fromm C: Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2015;September;66(3):222-229.e1.

4. Motov S, Yasavolian M, Likourezos A, Pushkar I, Hossain R, Drapkin J, Cohen V, Filk N, Smith A, Huang F, et al.: Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2017;August;70(2):177–84.

5.Dove D, Fassassi C, Davis A, Drapkin J, Butt M, Hossain R, Kabariti S, Likourezos A, Gohel A, Favale P, et al.: Comparison of Nebulized Ketamine at Three Different Dosing Regimens for Treating Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind Clinical Trial. Annals of Emergency Medicine. 2021;December;78(6):779–87.

6.Patrick C, Smith M, Rafique Z, Rogers Keene K, De La Rosa X: Nebulized Ketamine for Analgesia in the Prehospital Setting: A Case Series. Prehospital Emergency Care. 2023;February 17;27(2):269–74.

FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina
FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit fbefast.com for more information.