Articles That May Change Your Practice: Low-dose Ketamine for Acute Pain

Abstract

The management of acute pain in the transport setting and the emergency department (ED) is an important issue that is sometimes overlooked. The analgesic ladder in managing acute pain, ranging from acetaminophen and nonsteroidal anti-inflammatory agents to opioids and regional blockade of pain transmission, is the mainstay of treatment. There is always a concern in balancing effective pain management and the risk of side effects, including hypotension, respiratory depression, and hypoxemia. This is particularly true with repeated analgesic doses or in patients with comorbid conditions that put them at increased risk of these side effects. Russell D. MacDonald, MD, MPH, FCFP, FRCPC, is the medical director and chair of the Quality Care Committee at Ornge Transport Medicine; an associate professor at the University of Toronto; and an attending staff member at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. He can be reached at [email protected]. Selma Alqattan, MB BCh, BAO, SBEM, is a fellow in the trauma track of the emergency medicine fellowship program in the Division of Emergency Medicine, Department of Medicine, University of Toronto, Ontario, Canada.