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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90

u/Praxician94 Little Turkey (Physician Assistant) Jun 20 '25

“This is what killed Matthew Perry except there’s no hot tub here so it’s perfectly safe!”

50

u/MrPBH ED Attending Jun 20 '25

Like the med student who mentioned Michael Jackson when our patient was asking what propofol was.

"It's the drug that Michael Jackson overdosed on!"

"Shut the hell up Kenneth!"

Am I old? I guess I am old now.

11

u/Equivalent-Lie5822 Paramedic Jun 20 '25

I use that line too. I’ve always wondered, who the hell would prescribe that to anyone on a regular basis? That’s like prescribing QID succinylcholine

8

u/Revolting-Westcoast Paramedic -> med student Jun 20 '25

You dont like holding your breath for a couple minutes after fasiculating to the point that you feel like you were stuck by a semi? Lame.

7

u/Equivalent-Lie5822 Paramedic Jun 20 '25

Nah that’s the stuff of nightmares to me. I’ve seen people use paralytics without sedation and I’m baffled by it. Why do you hate your patient and want to give them PTSD?