Sub-dissociative Dose Ketamine for Analgesia
Approved by the Emergency Nurses Association January 2018
Approved by the Society of Emergency Medicine Physician Assistants December 2017
Approved October 2017
As an adjunct to this policy, ACEP has prepared a Policy Resource Education Paper (PREP) titled, “Sub-dissociative Dose Ketamine for Analgesia.”
A joint policy statement of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society of Emergency Medicine Physician Assistants
Sub-dissociative dose ketamine (SDK), also referred to as low dose ketamine (LDK) is safe and effective for analgesic use in emergency departments. SDK is one “opioid sparing” modality. Benefits of SDK over opioids and other common analgesics include, improved pain relief, less respiratory depression, and maintenance of cardiac output. Emergency care providers should disclose to patients that SDK administration may trigger generally minor transient side effects, including nausea and temporary dysphoria.
As with any analgesic, observation and assessment of the patient’s response to SDK is indicated. Due to SDK’s excellent safety profile and activity as an analgesic, not an anesthetic, special administration procedures and/or monitoring are not required. SDK may be safely ordered and/or administered by emergency care providers under the same policies and procedures as other typical analgesics.
American College of Emergency Physicians. “Optimizing the Treatment of Acute Pain in the Emergency Department.” Policy Statement. Approved April 2017.
From ACEP Policy on Optimizing the Treatment of Acute Pain in the Emergency Department, April 2017
Administration of sub-dissociative dose ketamine (SDK) may be used either alone or as part of a multimodal approach to pain relief for traumatic and non-traumatic pain. Emergency care providers should disclose to patients that SDK administration may trigger generally minor, transient side effects. Administration of sub-dissociative ketamine should commence under the same procedures and policies as other analgesic agents administered by the nursing staff in the ED setting.