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?

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u/EnvironmentalLet4269 ED Attending Jun 20 '25

"pull out your phone and play the chillest spotify playlist you have" and they never listen.

So when we're about to liftoff I say "I wasn't kidding about the spotify, the music makes the medicine work" Then they pull the phone out.

I'll usually give 20-40 of propofol bolus and then slowly push the ketamine over 2 min.

Usually works well

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u/Tiradia Paramedic Jun 20 '25 edited Jun 20 '25

If you have never heard of these instruments they are super soothing. The Armenian duduk and oud are super awesome! When I’m having a stressful time at work I’ll put this on for myself and for the patients and it makes things go from a 100 to 25. duduk and oud music there is something ethereal about these instruments and they just strike a cord in your soul.