In the "years" I've been using Ketamine for RTA extrication I've only had
one experience of inappropriate behaviour. That was a young woman with
bilateral femoral fractures who obviously thought I was George Clooney
whilst travelling back to hospital in the ambulance... mind you I was
younger in those days. I was too embaressed to ask her on the ward what the
dream was.
Another male patient remembered seeing penguins, but he didn't appear
distressed by the experience.... and certainly didn't remember the "painful"
extrication.
Ray McGlone.
A&E Lancaster
BTW.... The Faculty A&E secretarial staff do have a pin up of him on their
wall at the Royal College of Surgeons.
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, April 30, 2003 5:02 PM
Subject: Re: Ideas please....
> 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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