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/jubbyboi ED Attending Jun 20 '25

Sedated a 7 year old for fracture reduction 2 days ago and the nurse said “you’re gonna love this! A lot of people pay money to do this and you get it for free”… so I guess that’s an option.

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u/MrPBH ED Attending Jun 20 '25

Oh man, as an addiction doc and father that makes alarm bells go off in my head.

I think these kind of lines are a great way to relieve the tension and anxiety of an adult patient, but a bad message to kids. It's sending the message that this medicine can be used recreationally and that lots of people do it.

These statements might be true, but it's the wrong message for a seven year old.

I'd prefer a message that emphasizes A) this medicine is going to make it so it doesn't hurt when we fix your arm and you don't remember it, and B) it might be scary, but I promise if it is scary, it won't last forever.

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u/Barbiedawl83 Jun 21 '25

When I had my wisdom teeth removed in high school they gave me a dose of liquid medicine in the office (still don’t know what it was) and they told me to take it like a shot. I was sheltered and hadn’t had any experience with alcohol so I didn’t know what they meant and later thought it was bad phrasing.