List Archives

Fri Aug 3 09:01:20 BST 2007

Ketamine is our drug of chose for trauma anesthesia. We know all the
data in the text book but when surgeons doing most of the intubation in
our trauma unit we found the ketamine as the safest drug to use. More
then that, our paramedics use it in the pre-hospital.

Eran Tal-Or M.D. M.H.A.
Trauma Unit 
Rambam Medical Center
Haifa Israel
www.airdoc.co.il

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of neil mullen
Sent: Friday, August 03, 2007 3:24 AM
To: trauma
Subject: ketamine in head injured patients

Oh, I just get the willies when someone says "I've used X drug Y times
and so it's safe".  I've heard about people using ketamine safely in
head trauma, and so I'm fairly certain that it doesn't ROUTINELY cause
significant increases in ICP. But how many times have I seen the phrase:
"Ketamine is contraindicated in head trauma because it causes increases
in ICP"?  Suppose the incidence of this is .1%. Has any one person used
it safely in 1000 patients with head trauma?  All you need is 1 case and
you don't have a leg to stand on.  There are just too many other drugs
to use in RSI in patients with head trauma.  There is no reason to use
ketamine when the preponderance of the world's literature says it isn't
safe.

  Neil Mullen MD, FACEP, FAAP
  Madigan Army Medical Center
  Tacoma, WA

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ketamine in head injured patients