Rajesh S Sehdev, MBChB, MSc, MRCP, Emergency Registrar; David A D Symmons, MBBS, DA(UK), FACEM, Emergency Physician; Korana Kindl, MBBS, Senior House Officer.
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Ketamine for rapid sequence induction in patients with head injury in the emergency department
Article first published online: 3 FEB 2006
DOI: 10.1111/j.1742-6723.2006.00802.x
Additional Information
How to Cite
Sehdev, R. S., Symmons, D. A. and Kindl, K. (2006), Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emergency Medicine Australasia, 18: 37–44. doi: 10.1111/j.1742-6723.2006.00802.x
Publication History
- Issue published online: 3 FEB 2006
- Article first published online: 3 FEB 2006
- Accepted 11 October 2005
- Abstract
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Keywords:
- head injury;
- intracranial pressure;
- ketamine
Abstract
Objective: To examine the evidence regarding the use of ketamine for induction of anaesthesia in patients with head injury in the ED.
Method: A literature review using the key words ketamine, head injury and intracranial pressure.
Results: Advice from early literature guiding against the use of ketamine in head injury has been met with widespread acceptance, as reflected by current practice. That evidence is conflicting and inconclusive in regards to the safety of using ketamine in head injury. A review of the literature to date suggests that ketamine could be a safe and useful addition to our available treatment modalities. The key to this argument rests on specific pharmacological properties of ketamine, and their effects on the cerebral haemodynamics and cellular physiology of brain tissue that has been exposed to traumatic injury.
Conclusion: In the modern acute management of head-injured patients, ketamine might be a suitable agent for induction of anaesthesia, particularly in those patients with potential cardiovascular instability.