CA Ketamine Study

RocketMedic

RocketMedic

Californian, Lost in Texas
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How are y'all liking ketamine out there? Anyone get a chance to use it yet? Thoughts and perceptions?
 
Riverside and San Bernardino county are not getting it until next month so we shall see then. From talking to a lot of other medics it isn’t going to be utilized by a decent amount because there is fear of having to calculate a 0.3mg/kg dose :(

Edit: as far as I know it’s only Riverside county and ICEMA (San Bernardino) who are doing the trial study. Alameda may also be doing it but I can’t confirm.
 
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You're kidding, right? Its literally a /4 calculation.
 
RocketMedic said:
You're kidding, right? Its literally a /4 calculation.
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Why do math when you could just give the 50mcg dose of Fentanyl? Has been the argument that I have heard most often used.

I really wish I was kidding. It does not take very much time at all to do some very simple division and multiplication.
 
When we ran out of epi preload we actually had to have training on how to mix epi 1:1,000 to make it epi 1:10,000. I seeing how many medics actually struggled with that math was a huge slap in my face. We argue for better pay but yet we can not do simple math?
 
The resurrection of Ketamine! I’m thrilled!
 
A major part of the problem is that fact this county hasn’t had a weight based medication in a long time. We’ve been spoiled with set doses for medications.

With how technology is nowadays the math isn’t hard. Hell there’s med math apps that do all the work for you.
 
Well, for adults, the set dose is going to be around 25mg....

Anyways, aside from critical math fear, how's it going?
 
CALEMT said:
A major part of the problem is that fact this county hasn’t had a weight based medication in a long time. We’ve been spoiled with set doses for medications.
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So why don’t they just do that with ketamine?

The problem with weight based dosing that no one talks about is that if you don’t have a recent, actual weight, you are just estimating your “weight based” dose anyway.
 
Well, it's not the best way to use it, but it's not the worst way either....
 
Med math? Oh no!

Ugh, if Alameda County gets it, they are going to have just one more thing to add to their overbloated ego. One of the most egocentric counties I have ever worked in and my least favorite. I suppose it will be a way for my current county to get it eventually (we usually follow suit like 30-40 years later).
 
Remi said:
The problem with weight based dosing that no one talks about is that if you don’t have a recent, actual weight, you are just estimating your “weight based” dose anyway.
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Handtevy.

EpiEMS said:
@DesertMedic66 I am cracking up at this...the med math...
Is this the protocol?
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Is this typical of "trial" protocols. That is one of the most complicated protocols for something simple I've ever seen. It's two pages to explain how to push a single medication.

No wonder why no one wants to use it.
 
NPO said:
Handtevy.



Is this typical of "trial" protocols. That is one of the most complicated protocols for something simple I've ever seen. It's two pages to explain how to push a single medication.

No wonder why no one wants to use it.
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Yes this is typical for our trial studies. When you break it down it’s not a whole bunch of information to remember. Our trial study for TXA is much more complicated.
 
DesertMedic66 said:
Yes this is typical for our trial studies. When you break it down it’s not a whole bunch of information to remember. Our trial study for TXA is much more complicated.
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Yeah it's just a lot of words to say something simple. But I could understand the fear of "did I forget something" with it being so complicated. It seems so "extra" what with the firefighter having to ride in if they give it, to having to make a drip out of it, etc...
 
NPO said:
Yeah it's just a lot of words to say something simple. But I could understand the fear of "did I forget something" with it being so complicated. It seems so "extra" what with the firefighter having to ride in if they give it, to having to make a drip out of it, etc...
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In my county the majority of fire departments are opting out on the trial and leaving it for the transport company. IMO it is not complicated at all. It’s a very little amount of “new” information.

The drip form is supposed to have less side effects which is why it was selected over IVP or IM.
 
DesertMedic66 said:
In my county the majority of fire departments are opting out on the trial and leaving it for the transport company. IMO it is not complicated at all. It’s a very little amount of “new” information.
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It just seems more complicated than it needs to be. The actual protocol isn't that complicated, it's just the way it's spelled out, like saying anything over 5 on the pain scale, etc. Like why did that need to be defined? What's wrong with provider discretion?
 
0.3 mg/ kg is pretty straightforward even for paramedics who don’t do a lot of “thankin’”. This is downright deplorable and by no means a reflection of every California paramedic*.

I think Stanislaus County (Modesto) was going to partake in some sort of Ketamine trial as well.

*my non-inclusive waiver.
 
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