The American College of Emergency Physicians (ACEP) announced on Jan. 18 that guidelines for using ketamine in the emergency department have been updated for the first time since 2004 and that its use has been expanded to include adults and babies between three and 12 months of age. Along with the new guidelines, published online in the Annals of Emergency Medicine, are the results of the first randomized, controlled trial of ketamine plus propofol vs. propofol alone in the emergency department, which showed less respiratory depression and more provider satisfaction for the ketamine plus propofol combination.
“Since the guidelines were last updated, there has been sufficient emergency department research in adults to support expansion of ketamine use beyond children,” says lead author Steven M. Green, MD, in an ACEP statement. “In addition, the body of research supports the expansion of ketamine use beyond children younger than previously recommended, i.e., between three and 12 months of age. We further recommend that emergency physicians administer ketamine intravenously instead of intramuscularly whenever feasible, and that certain other medications not be routinely co-administered.”
