DO NOT GIVE A BENZODIAZEPINE WHILE THE PATIENT IS STILL TRAPPED. You run
a severe risk of respiratory depression and obstruction while will give
you a shed load of trouble. If the patient is behaving oddly, give more
ketamine. If you are seriously bothered about emergence phenomena give a
bit of midazolam when in hospital as the ketamine is wearing off. I have
only seen it once in an adult, and that wasn't very impressive - no
worse than the effect of brief hypoxia.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of
[log in to unmask]
Sent: 30 April 2003 14:45
To: [log in to unmask]
Subject: Re: Ideas please....
In message <[log in to unmask]> Tom Hughes
<[log in to unmask]> writes:
> On my [limited] prehospital experience with trauma and ketamine, it
> seems to be useful to cover short [painful] procedures, but I found it
> difficult to titrate in the back of an ambulance, added to the
> interesting neuropsychological effects.
>
<SNIP>
We routinely add benzodiaz to ketamine in Staffs to address the latter
point.
Need to top up usually every 15 minutes if maintaining anaesthesia with
ETT in situ.
Can run into probs with increased resps if borderline pneumo.
Anton
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