[Integrated use of ketamine in emergency care]

Ketamine has emerged as a key drug in emergency medicine in recent years due to its rapid onset of action, hemodynamic stability properties and wide applicability. However, Hungarian regulation still limits its use mainly to anesthetic indications. The aim of this study was to review the literature on the emergency use of ketamine, with particular reference to its role in prehospital and intrahospital analgesia, sedation and rapid sequence intubation (RSI) protocols. A structured literature search was performed in PubMed, Scopus and Cochrane Library databases, including relevant human studies from 2010 to 2024, and supplemented by selected pre-2010 landmark studies that are pivotal in the historical and clinical context of ketamine use in emergency care. The retrieved publications were thematically categorized, and narrative synthesis was applied. Based on 82 studies reviewed, ketamine was found to be effective and safe in acute analgesia, procedural sedation, agitation management and RSI. Side effects are predominantly mild and well managed. Previous contraindications in patients with head injury are increasingly questioned in the current international literature. The place of ketamine in emergency care is evidence-based. Its use fits well into modern multidisciplinary emergency protocols. It is recommended to update national recommendations in line with international practices. Orv Hetil. 2026; 167(42): 1679-1685.