Taming The SRU
Taming The SRU - September 09, 2020 - By Hill J
"In our most recent journal club, we took a look at 3 articles focused on the use of ketamine in the Emergency Department. When treating pain with ketamine, does a rapid administration of ketamine result in more dysphoria? When used for RSI, is ketamine more hemodynamically stable than etomidate? When using ketamine for procedural sedation in adult patients, does pre-treatment with versed or haldol decrease clinically significant emergence agitation?...
Take-homes
- Ketamine is not necessarily superior to etomidate to prevent peri-intubation hypotension
- Large incidence of ketamine-related hypotension in medical patients (more likely to be catecholamine depleted) fits with prior data demonstrating benefit of catecholamine release
- Not practice changing, but provides counterpoint to recent trend toward increasing ketamine use in patients expected to become hypotensive"