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/Equivalent-Lie5822 Paramedic Jun 20 '25

I tell them “you’re about to go to a very happy place”. It also depends on how much you’re giving them. It has levels to it. 25-50, most people (key word being most) aren’t gonna be too delirious. IM doses of 250, they’re either gonna be seeing demons or pink unicorns and have a thousand yard stare going on.