We are seeing an increased usage of intermittent IV ketamine for non-sedation indications like pain and agitation, especially in our movement disorder patients. Does your site allow nurses to administer intermittent or PRN IV ketamine? If so, what parameters are used to distinguish from mod-deep sedation? Can you share your policy? Thanks! -Melody Sun, CHOC Children's

It has recently come to our attention that Trissel's designates Ketamine and LR as incompatible at Y-site. Our anesthesia group disputes this assertion, saying the study it is based on is flawed and ORs everywhere have been using Ketamine+LR for decades with no issues. Our nurses rely exclusively on Trissel's/Lexi to determine compatibility, so this has caused some concern.

Have any of your institutions discussed this incompatibility with anesthesia or ORs? Do you have any scenarios where you use blanket exceptions to compatibility designations in Trissels?

How do you currently infuse ketamine at your organization? Via PCA module? Syringe pump? Via IV bag?

Do you treat your C3s the same as your C2s in regard to securing the infusion via lock box?

Thank you for your response,
Stacie Ethington MSN, RN-BC
Medication Safety Nurse Specialist
Nebraska Medicine

Is anyone using ketamine infusion for post-op pain control that would be willing to share their protocols? What unit(s) do you allow to run this and what monitoring guidelines do you use?

Have any institutions been asked to load concentrated ketamine (100 mg/ml) in the ED ADM? We currently have the 10 mg/ml strength loaded, but the concentrated ketamine is sent from the Pharmacy patient-specific.