Ketamine-- how to prepare patients?

[u/rainbowsforeverrr]

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?

[u/FraeshFeesh]

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.

[u/HockeyandTrauma → u/FraeshFeesh]

I've done this with kids too. I ask them what they'd like to dream about, and then as I'm giving it I have them recall that.

[u/metforminforevery1 → u/HockeyandTrauma]

Yeah same. And now that it’s summer, I ask them about their favorite summer things or trips and they usually talk about the beach and Disneyland and visiting cousins and stuff. The kids never seem to have bad trips. The adults I tell them to picture their favorite vacation or dream vacation. Usually the bad trips are the traumas who are on some substance and there’s not a lot of time to talk them down anyway