Page 164 - PJ MED OPS Handbook 8th Ed

Ketamine Drip Dosing Tables
Mix 1,000mg (2 vials of 500mg/5mL) in 250mL of saline (4mg/mL solution)
Patient’s Weight (kg)
Dose 40 60 80 100
mg/kg/hr μg/kg/min Infusion Rate, mL/hr
Ketamine drip rate for dial flow or IV pump (starting dose highlighted)
0.75 13 10 15 20 25
1.0 17 13 20 27 33
1.25 21 17 25 34 42
1.5 25 20 30 40 50
1.75 29 24 35 47 59
2.0 33 27 40 53 67
Ketamine drip count for 15 drips/mL tubing (starting dose highlighted)
mg/kg/hr μg/kg/min Infusion Rate, 1 drip/X seconds
0.5 8 1/35 1/24 1/18 1/9
0.75 13 1/27 1/18 1/14 1/8
1.0 17 1/18 1/12 1/9 1/7
1.25 21 1/15 1/10 1/8 1/6
1.5 25 1/12 1/8 1/6 1/5
1.75 29 1/11 1/7 1/6 1/5
2.0 33 1/9 1/6 1/5 1/4
Ketamine drip count for 10 drips/mL tubing (starting dose highlighted)
mg/kg/hr μg/kg/min Infusion Rate, 1 drip/X seconds
0.5 8 1/53 1/36 1/27 1/14
0.75 13 1/41 1/27 1/21 1/12
1.0 17 1/27 1/18 1/14 1/11
1.25 21 1/23 1/15 1/12 1/9
1.5 25 1/18 1/12 1/9 1/8
1.75 29 1/17 1/11 1/9 1/8
2.0 33 1/14 1/9 1/8 1/6
Procedural Sedation
Step 1: Bolus (1.0–2.0mg/kg) 80–160mg ketamine IV/IO over 60 seconds (250–400mg IM if necessary).
Step 2: Consider adding (start low, give more):
• 25–100μg fentanyl IV/IO
• 1–4mg midazolam IV/IO
Step 3: May need to repeat doses as below if procedure lasts longer than 10–15 minutes.
• Ketamine every 10–15 minutes
• Fentanyl every 15–30 minutes
• Midazolam every 30–60 minutes
(REFERENCE: Joint Trauma System CPG- Analgesia and Sedation Management During Prolonged Field Care,
May 2017 (CPG ID: 61))
162 n Pararescue Medical Operations Handbook / 8th Edition