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iceemike1
12-13-2009, 06:26 AM
Just was wondering what people were using for their doses of a ketamine dart. In school, we were taught a mixture of Ketamine/versed/glyco but in practice, I've seen it a couple times and no one mixes agents--straight Ketamine only at 0.5 mg/kg. Does anyone add the glyco and or versed and if so, what dose do you use? I really like the idea of adding the glyco to try to prevent the excess secretions from the ketamine, and I'm a bit leary not giving the versed with the ketamine--although I've read less than 1mg/kg should not produce hallucinations. But so far all the MDA's do not believe in mixing and was wondering if 30 mcg/kg of versed and 10 mcg/kg of glyco was about right.

Thanks,
Mike L.
beekahx4
12-13-2009, 07:40 AM
never heard of a ketamine dart.
MmacFN
12-13-2009, 08:14 AM
Somehow i thought this was answered on another thread...

anywho, I do 5 mg/kg for the dart and give versed and glyco IV after the fact.
iceemike1
12-14-2009, 03:43 PM
Do you still get the drying effect of the glyco this way or are you battling secretions with induction?

I think I posted this already but I was at work and couldn't find where I did!
MmacFN
12-14-2009, 04:32 PM
I seem to do ok with IV glyco. Cant say one is better than the other since i just dont do the IM glyco with ketamine. Seems like another stick and more volume...

I see IM ketamine as a last resort and as the only 'safe' way to soften someone for induction... otherwise, i wouldnt iM them.
My_brain_hurts
12-16-2009, 05:03 PM
Still in didactic phase, so ignor me if I'm dumb.

My instructors have mentioned the joys and usefullness of ketamine darts, and they didn't mention mixing anything else with it. Keep in mind though, they are not talking about simple IM admin to induce, they mean combat situations in the ER. I'm sure if they were using IM ketamine to induce in a controlled environment they would pre/concurrently medicate.
Dominues
03-16-2010, 06:07 PM
Typically only use a dart for mentally challenged patients for IV starts.
Anywhere from 25 to 125 mg IM with no additives in preop. Wait 15 minutes (pt is not left alone, I stay with them) then you should be able to start iV. Most of these patients are already salivating, no problems with induction.

I am not a big fan of giving large volumes of anything IM. The more additives, the larger the volume. Our ketamine is 50 mg/ml.