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/Ineffaboble Jul 09 '25

“If you have further questions, I suggest you ask Alice.” /s

Serious answer: for procedural sedation make sure you are well up into the dissociative amnestic dosing range. There’s a very nasty middle ground where patients are partially dissociated but still aware and it is extremely unpleasant; you don’t want to put them there by undershooting and if you know the doses, you can be the one to advocate with the MD for your patient to make sure they get what they need.