On a daily basis we, as emergency medicine providers, discuss drugs and their side
effect profiles. We often survey our colleagues regarding rare reported phenomena
that have not been previously encountered. In my short emergency medicine career,
I've heard the praises of ketamine thousands of times over: “Ketamine is safe and
effective.” “You can never give too much ketamine.” “You can theoretically get an
emergence reaction, but I haven't seen it.” I will be the first to admit that I used
ketamine for nearly every procedural sedation that I performed—until my little adventure
to the K-hole. What you're about to read acutely magnifies a mantra that I'm sure
many of us heard throughout medical school: “The right patient, the right medication,
the right dose, the right route.” Of the many lessons to be learned, mine was in my
approach to resident education regarding sedation. All drugs can be unsafe. The rare
side effects that “we'll never see” certainly happen—we know this.
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Article info
Publication history
Published online: September 24, 2019
Accepted:
June 30,
2019
Received:
June 23,
2019
Footnotes
The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army and Department of Defense or the U.S. Government.
Reprints are not available from the author.
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Copyright
Published by Elsevier Inc.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Comments on Medication Safety in the Emergency Department After a Trip to the K-HoleJournal of Emergency MedicineVol. 59Issue 2
- PreviewWe read with fascination the account of an emergency physician having experienced a severe adverse reaction after receiving intravenous (IV) ketamine for procedural sedation (1). We commend Dr Simon for sharing her traumatic episode. Her account serves as a vivid reminder that ketamine, despite popularity among emergency medicine providers, carries a unique toxicity profile. Nonetheless, we contend that the title of the commentary may be misleading and create undue stigmatization against a tool with a record of dependability and cardiorespiratory safety for procedural sedation (2).
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