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dc.contributor.authorCowley, Alan
dc.contributor.authorWilliams, Julia
dc.contributor.authorWesthead, Pete
dc.contributor.authorGray, Nick
dc.contributor.authorWatts, Adam
dc.contributor.authorMoore, Fionna
dc.date.accessioned2019-09-12T12:20:04Z
dc.date.available2019-09-12T12:20:04Z
dc.date.issued2018-03
dc.identifier.citationCowley, A. et al, 2018. A retrospective analysis of ketamine administration by critical care paramedics in a pre-hospital care setting. British Paramedic Journal, 2 (4), 25-31.en_US
dc.identifier.issn1478-4726
dc.identifier.doidoi.org/10.29045/14784726.2018.03.2.4.25
dc.identifier.urihttp://hdl.handle.net/20.500.12417/188
dc.description.abstractAbstract published with permission. Objective: This project aims to describe pre-hospital use of ketamine in trauma by South East Coast Ambulance Service critical care paramedics and evaluate the occurrence of any side effects or adverse events. Methods: A retrospective analysis of patients receiving pre-hospital ketamine for trauma between 16 March 2013 and 30 April 2017. Administrations were identified from Advanced Life Saving Interventions and Procedures reports submitted by the clinician and, later, from an electronic database. Each was scrutinised for patient demographics, doses and reports of side effects or adverse events. Results: A total of 510 unique administrations were identified. Following the exclusion of 61 records, 449 (88.0%) administrations remained. The most common indication for administration of ketamine was lower limb injury, with 228 (50.8%) administrations. Ketamine was only administered intravenously, and the median dose of ketamine for all administrations was 30 mg (interquartile range 20‐40 mg). The gender split was dominated by males who accounted for 302 (67.3%) administrations compared to 147 (32.7%) females. The median age of patients was 44 years (interquartile range 28‐58 years), with women on average being older than men. Telephone calls to a consultant were made for 243/449 (54.1%) of the administrations, reflecting a need for sanctioning of the drug, advice on dosages or indications, for example. Conclusions: Critical care paramedics within a well governed system are able to safely administer ketamine within an approved dosing regimen under a Patient Group Direction. Median doses are in keeping with nationally approved guidelines. Reported side effects were within the described frequencies in the British National Formulary. Prospective studies are now needed in order to confirm the safety and efficacy of ketamine administration among the advanced paramedic population.
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectAnalgesiaen_US
dc.subjectKetamineen_US
dc.subjectEmergency Medical Techniciansen_US
dc.titleA retrospective analysis of ketamine administration by critical care paramedics in a pre-hospital care settingen_US
dc.source.journaltitleBritish Paramedic Journalen_US
dcterms.dateAccepted2019-07-23
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2019-07-23
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2018-03
html.description.abstractAbstract published with permission. Objective: This project aims to describe pre-hospital use of ketamine in trauma by South East Coast Ambulance Service critical care paramedics and evaluate the occurrence of any side effects or adverse events. Methods: A retrospective analysis of patients receiving pre-hospital ketamine for trauma between 16 March 2013 and 30 April 2017. Administrations were identified from Advanced Life Saving Interventions and Procedures reports submitted by the clinician and, later, from an electronic database. Each was scrutinised for patient demographics, doses and reports of side effects or adverse events. Results: A total of 510 unique administrations were identified. Following the exclusion of 61 records, 449 (88.0%) administrations remained. The most common indication for administration of ketamine was lower limb injury, with 228 (50.8%) administrations. Ketamine was only administered intravenously, and the median dose of ketamine for all administrations was 30 mg (interquartile range 20‐40 mg). The gender split was dominated by males who accounted for 302 (67.3%) administrations compared to 147 (32.7%) females. The median age of patients was 44 years (interquartile range 28‐58 years), with women on average being older than men. Telephone calls to a consultant were made for 243/449 (54.1%) of the administrations, reflecting a need for sanctioning of the drug, advice on dosages or indications, for example. Conclusions: Critical care paramedics within a well governed system are able to safely administer ketamine within an approved dosing regimen under a Patient Group Direction. Median doses are in keeping with nationally approved guidelines. Reported side effects were within the described frequencies in the British National Formulary. Prospective studies are now needed in order to confirm the safety and efficacy of ketamine administration among the advanced paramedic population.en_US


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