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Ketamine in prehospital care

The relief of pain is an essential component of prehospital care and, when required is usually administered on completion of the primary survey. For simple analgesia morphine sulphate titrated to the clinical response and preceded by an antiemetic is usually effective, for example, in the relief of pain in chest trauma or myocardial infarction. For patients with multiple injuries and for those patients requiring manipulation and splintage of fractures and for entrapments and difficult extrications ketamine is a safe and effective option, which avoids the potential decrease in blood pressure and respiratory depression that is associated with opioid analgesia. This paper reports the personal experience in the prehospital administration of ketamine by a non-anaesthetist working as an immediate care practitioner as part of a British Association for Immediate Care (BASICS) Scheme.