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The Use of Ketamine for the Management of Acute Pain in the Emergency Department

Davis, Wesley D., DNP, ENP-C, FNP-C, AGACNP-BC, CEN; Davis, Kristina A., DNP, ENP-C, FNP-C, AGACNP-BC, CEN; Hooper, Katie, PharmD

Section Editor(s): Weant, Kyle A. PharmD, BCPS, FCCP; Column Editor

Advanced Emergency Nursing Journal: April/June 2019 - Volume 41 - Issue 2 - p 111–121
doi: 10.1097/TME.0000000000000238

Ketamine has been used as an anesthetic agent for over 50 years. At the upper end of the dosing range, it displays dissociative anesthetic and amnestic effects, while at lower doses, it acts as an analgesic and demonstrates opioid-sparing capabilities. Ketamine is unique in its preservation of hemodynamic stability and respiratory function, and is used extensively in the emergency department (ED) for procedural sedation and the facilitation of brief painful procedures. Despite evidence supporting its safety and efficacy as an analgesic agent at sub-dissociative doses, its use in the ED for the management of acute pain remains uncommon. New guidelines were published in July 2018 by the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists that provide a framework for identifying patients who are likely to benefit from the use of Ketamine in an acute pain setting.

University of South Alabama, Mobile (Dr W. D. Davis); Crook County Medical Services District, Sundance, Wyoming (Dr W. D. Davis); Rocky Mountain University of Health Professions, Provo, Utah (Dr K. A. Davis); and Baylor University Medical Center, Dallas, Texas (Dr Hooper).

Corresponding Author: Wesley D. Davis, DNP, ENP-C, FNP-C, AGACNP-BC, CEN, Department of Adult Health Nursing, University of South Alabama, 5721 USA Dr, North, Mobile, AL 36688 (

Disclosure: The authors report no conflicts of interest.

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