Introduction
Although ketamine use in emergency medicine is widespread, studies investigating
its prehospital use are scarce. Our objective was to assess the self-reported modalities of
ketamine use, knowledge of contraindications and adverse events associated with the use of
ketamine by physicians through a prospective online survey.
Methods
The survey was addressed to physicians working for Air-Glaciers, a Swiss alpine
helicopter-based emergency service (HEMS) and was available between 24 September and 23
November 2018. We enrolled 39 participants (participation rate of 87%), and collected data
regarding characteristics of physicians, mode of use of ketamine, knowledge of contraindications
and side effects linked to ketamine administration, as well as a clinical scenario investigating
analgesia strategy
Results
Ketamine was considered safe, and judged irreplaceable by most physicians. The main reason for ketamine use was acute analgesia during very painful procedures, such as femoral
fracture manipulation. Most physicians reported using opiates and midazolam concomitantly,
while monitoring use and oxygen administration were used infrequently. The most frequently
reported side effect was hallucinations, mainly visual and auditory. There was a general lack of knowledge among physicians regarding contraindications to the use of ketamine. Conclusion This study represent a picture of current state of the practice and knowledge for the
use of ketamine in a pre-hospital, remote environment and suggest room for improvement in terms of knowledge of the contraindications.