EMED-L ARCHIVES

Subject: emed-l Ketamine and Fentanyl



Timestamp:1:96

Date: Mon, 23 Oct 1995 12:35:42 -0400 (EDT)
From: "Jeffrey S. Fine" 
Subject: emed-l Ketamine and Fentanyl


More on things we've talked about before.

How many of you (or who of you) are using ketamine on a regular basis?  
How often.  Do you always have an IV in place or do you ever use IM 
ketamine without an IV.

Ditto the same questions for fentanyl.

Jeff Fine
Pediatric Emergency Services
Bellevue Hospital
NYC
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Date: Mon, 23 Oct 1995 19:31:33 EDT
From: AFQX49A@prodigy.com (DR ALAN D CLARK)
Subject: emed-l Ketamine and Fentanyl


-- [ From: Alan D. Clark, M.D. * EMC.Ver #2.10P ] --

-------- REPLY, Original message follows --------
 
[ snipped for clarity - see above - TJH ]

 I use Ketamine for tough ped lacerations about once a week,usually IM 
(2 - 2.5 mg/kgKetamine with .01mg/kg Atropine and 0.05mg/kg of Versed).
With this combo I get dissociation and nystagmus as early as five min
IM (range 5min - 12min) and good control for ED repair.

Fentanyl  - IV only. 50- 100micrograms in a adult, and always with
Versed (for dislocation reductions, abscess drainage or any short
painful procedure).  4 out of 5 patients will ask me when I am going to
do the procedure about 15 min after it is done - a testament to the
amnestic effects of Versed (or Valium for that matter). 

Use a conscious sedation protocol with any of the above (pulse ox,
monitor,etc)..

Alan Clark M.D, FACEP



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