I'm Anton Helman, and I'm Teresa Chin.

And this is the Journal Jam podcast, where we blend interviews with leading researchers of important emergency medicine journal articles,

and the best of crowdsourced social media-based opinions of emergency

medicine providers from around the world.

You'd think ketamine was in the ED drinking water.

Not only has this NMDA receptor antagonist been used effectively for procedural sedation and

rapid sequence

intubation, but also for things like delayed sequitubation and the agitated patient

who you need to intubate to buy time for pre-oxygenation, for life-threatening asthma,

as it's got bronchidilatory and anxiolytic effects, as anxiolytic for severely agitated psych patients and excited

delirium syndrome. Ketamine's even been used effectively for refractory status epilepticus and for

head-injured patients as it's thought to have neuroprotective effects. If all those indications

weren't enough, ketamine may be an effective analgesic for patients with moderate to severe pain in the ED.

And that's what this journal jam is all about.

Whether sub-dissociative low-dose ketamine is effective to help alleviate pain,

the pain that we see with our patients in every shift.

Oligal analgesia occurs in up to 43% of patients in the ED.

So, wait, you're saying that 43% of the patients that we see that have pain

don't get enough pain medication to control their pain adequately.

Yes, but I think that there is the case to me made that we could be more vigilant and relieve

that suffering.

Absolutely.

...