r/emergencymedicine • u/rainbowsforeverrr • Jun 20 '25

Advice Ketamine-- how to prepare patients?

Hi folks, ER nurse here. I'm curious how you talk to patients about ketamine admin for procedures or for intractable pain relief. I give it fairly often but I still haven't found the right way to prepare patients (or parents of littles) for the psychotropic effects. I've never used ketamine personally, but it seems to be a very intense experience that ought to be part of the informed consent conversation. What is our ethical obligation?

104 Upvotes

96% Upvoted

126 comments sorted by

View all comments

268

u/FraeshFeesh Pharmacist Jun 20 '25

One interesting thing about ketamine is that a patients experience can actually change depending on their feelings leading up to a procedure. If I’m in the room during a sedation I usually try to have a patient recall a good memory/experience, really anything that has the potential to prevent an emergence reaction is worth it in my book.

45

u/Firemedic623 Paramedic Jun 20 '25

I always do this in the field as well and it has worked well for my patients.

48

u/Tiradia Paramedic Jun 20 '25

200% this! As I’m drawing the meds up I tell em to find a happy memory and think back on it. As I’m pushing the meds I tell them to keep that memory in mind and just let go they are safe and in good hands. Never had a bad emergence. If I have the time though I’ll make a quick drip and give it over 10 mins usually helps as well.