Monday, December 6, 2010
Rapid Sequency Intubation Part 1
A new podcast on Rapid Sequence Intubation is available for free in the iTunes store.
Sunday, December 5, 2010
Ketamine is a great drug for EMS
Ketamine is perhaps one of my favorite drugs to use for care of the critically injured and yet it seems to have such a poor reputation in EMS. Ketamine is a drug that causes dense analgesia and maintains sympathetic tone, airway control, and respiratory drive. It is commonly used in Europe, the military, burn centers, and trauma centers.
It's use in prehospital care is very limited in the US. It is a cousin of LSD so it can cause some strange and vivid nightmares. Also it increases secretions. For these reasons when we use it we typically give a medication that decreases secretions such as robinol or atropine. Next a benzodiazepine such as versed or valium is given to cause antegrade amnesia. This will make it so the vivd dreams are not remembers. Then we administer the ketamine. It is a very dense anagesic so giving additional opiates is not required. Read more about this drug in my book on page 381.
It's use in prehospital care is very limited in the US. It is a cousin of LSD so it can cause some strange and vivid nightmares. Also it increases secretions. For these reasons when we use it we typically give a medication that decreases secretions such as robinol or atropine. Next a benzodiazepine such as versed or valium is given to cause antegrade amnesia. This will make it so the vivd dreams are not remembers. Then we administer the ketamine. It is a very dense anagesic so giving additional opiates is not required. Read more about this drug in my book on page 381.
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