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Wed Aug 27 19:09:08 BST 2008

Hellow,

Thats a good discussion. what if i had a polytraumatized patient ,severe head trauma and hypotensive, and i had with me Valium and ketamine, would be be ok to use it for intubation without any  problem.
i have asked this question as i am a gen.surg resident and quite often have to intubate pts.

Thank You,

Dr.Asif Huda Ansari

 Please send a copy to e-mail listed below, so that I can reply at the earliest.

1. asifhansari at gmail.com

--- On Wed, 8/27/08, trauma-list-request at trauma.org <trauma-list-request at trauma.org> wrote:
From: trauma-list-request at trauma.org <trauma-list-request at trauma.org>
Subject: trauma-list Digest, Vol 62, Issue 28
To: trauma-list at trauma.org
Date: Wednesday, August 27, 2008, 2:00 PM

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When replying, please edit your Subject line so it is more specific
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Today's Topics:

   1. Matthew Sena is out of the office. (Matthew Sena)
   2. Re: trauma-list Digest, Vol 62, Issue 25 (Gert Egil Frahm-Jensen)
   3. Re: Ketamine in trauma (William Bromberg)
   4. Re: Ketamine in Trauma (Sohail Muzammil)
I will be out of the office starting  08/25/2008 and will not return until
11/20/2008.

If this is an emergency, please contact Jennie Salinas at 734 8356 and she
can contact me directly.  Alternatively you can email me at the following
address and I will get back to you as soon as possible:

matthewsena2004 at yahoo.com

Thank You
I ordered from Amazon two weeks ago, and was told a couple of days ago 
that the book is out of print and they will not be able to obtain more 
copies.

Placed an order with the GPO today without any problems.

Regards,
Gert

KMATTOX at aol.com wrote:
> The GPO is http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2008-August/_http://bookstore.gpo.gov/collections/war-surgery.jsp_ 
> (http://bookstore.gpo.gov/collections/war-surgery.jsp) 
>  
> You can also get it from Amizon.com, but it will put you on back  order.  

> The wait is about the same from both sites.   
>  
> k
>  
>  
>  
>  
> In a message dated 8/24/2008 8:36:19 A.M. Central Daylight Time,  
> Sise.Mike at scrippshealth.org writes:
>
> Norm,  and others who have ordered the War Surgery book,
>
> What's the government  website to order?
>
> Mike Sise,
>
> San  Diego
>
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Don,

I appreciate your expertise — not to mention your well-honed turn of
phrase (salivate like a sailor on leave — I love it!). 

Bill

>>> <bensonblues at comcast.net> 8/26/2008 2:40 AM >>>
Bill,

My practice is to use just enough ketamine so they won't look at me
while I do what I need to do, usually, around 1 mg/kg IV. The accepted
dose is 1 to 4 mg/kg, or, as my crazy nurse anesthetist says "1 -
1000".
They used ketamine on me when doing my rotator cuff, they never
intubated me, and I don't remember anything.

I had case today that you might easily see in a trauma patient,
especially in the SICU the first day post-op. A woman presented to the
ED with CC of SOB. She gives a great history without difficulty, doesn't
seem dyspneic, and exam is unrmarkable. Ten minutes later, she has an O2
sat of 60%, was thrashing wildly about on the stretcher (big girl, I
might add), and coughing up pink frothy sputum. I gave her 100 mg
ketamine, and she immediately turned into a zombie and I easily
intubated her while she was still breathing. She had acute LV failure,
and I don't as of yet know why but I suspect cocaine. In Detroit, the
trauma victim who is a victim of violent crime has cocaine in their
urine if they have anything. And,...

Sorry, back to ketamine: I think using ketamine in the trauma victim is
safe, compassionate, and economic in alleviating pain and suffering. I
even use it in 'stable' ED patients needing a chest tubes or other
things. They will salivate like a sailor on leave, but glycopyrholate,
atropine, and/or a Yankauer should be all you need for that. I give a
benzodiazepine (either lorezepam or diazepam) after the important things
are done. But, I'm open to criticism...

Don Benson, DO
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In the Kashmir earthquake of Oct 2005 Ketamine was almost exclusively
used in large numbers of severely injured patients (mostly with full
stomachs) under the most trying conditions. I was in the thick of it
for the first two weeks as a surgeon and my anaesthetist colleague had
a syringe full of ketamine in one pocket and another full of valium in
the other pocket. These he would dispense picking his way through the
makeshift operating tables we had established (but that's another
story).

The practice did not result in any complications that I can recall and
generated some papers the references to which I can find if anybody is
interested.

Regards
S Muzammil, FRCS
Dept of Orthopaedics
Combined Military Hospital
Pano Aqil Cantt, Pakistan

On 8/26/08, trauma-list-request at trauma.org
<trauma-list-request at trauma.org> wrote:
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