Ketamine in prehospital care

Area of Science:

• Emergency Medicine
• Prehospital Care
• Pain Management

Background:

• Pain relief is crucial in prehospital care, typically administered after the primary survey.
• Morphine sulfate with an antiemetic is standard for simple analgesia (e.g., chest trauma, myocardial infarction).
• Opioid analgesia can cause hypotension and respiratory depression, posing risks in trauma settings.

Purpose of the Study:

• To evaluate ketamine as a safe and effective prehospital analgesia option.
• To explore ketamine's utility for patients with multiple injuries, fractures, entrapments, or difficult extrications.
• To report personal experience with prehospital ketamine administration by a non-anesthetist.

Main Methods:

• Personal experience of a non-anesthetist immediate care practitioner.
• Administration of ketamine in a prehospital setting within a British Association for Immediate Care (BASICS) Scheme.
• Focus on patients requiring advanced pain management beyond simple analgesia.

Main Results:

• Ketamine was identified as a safe and effective option for prehospital pain management.
• Ketamine avoided the blood pressure decrease and respiratory depression associated with opioids.
• Demonstrated utility in complex trauma, fracture manipulation, and extrication scenarios.

Conclusions:

• Ketamine is a valuable alternative to opioids for prehospital pain relief in specific patient groups.
• Non-anesthetists can safely administer ketamine in prehospital settings.
• Further adoption of ketamine may improve outcomes in prehospital trauma care.