Approved January 2018 by the Emergency Nurses Association
Approved December 2017 by the Society of Emergency Medicine Physician Assistants
Originally approved October 2017
As an adjunct to this policy statement, ACEP has prepared a policy resource and education paper (PREP) titled "Sub-dissociative Ketamine for Analgesia"
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.