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Titolo:
KETAMINE SAFETY PROFILE IN THE DEVELOPING-WORLD - SURVEY OF PRACTITIONERS
Autore:
GREEN SM; CLEM KJ; ROTHROCK SG;
Indirizzi:
LOMA LINDA UNIV,MED CTR,EMERGENCY MED RESIDENCY PROGRAM,A-108,11234 ANDERSON ST LOMA LINDA CA 92354 LOMA LINDA UNIV,SCH MED,DEPT EMERGENCY MED LOMA LINDA CA 92354 ORLANDO REG MED CTR INC,DEPT EMERGENCY MED ORLANDO FL 00000
Titolo Testata:
Academic emergency medicine
fascicolo: 6, volume: 3, anno: 1996,
pagine: 598 - 604
SICI:
1069-6563(1996)3:6<598:KSPITD>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
PEDIATRIC PROCEDURES; ANESTHESIA; SEDATION;
Keywords:
KETAMINE; SEDATION; COMPLICATIONS; SAFETY PROFILE; DEVELOPING WORLD; MONITORING;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
S.M. Green et al., "KETAMINE SAFETY PROFILE IN THE DEVELOPING-WORLD - SURVEY OF PRACTITIONERS", Academic emergency medicine, 3(6), 1996, pp. 598-604

Abstract

Objective: To evaluate the safety profile of ketamine when used to facilitate surgical procedures in the less controlled setting of developing world, rural hospitals. Methods: A survey addressing clinical experience with ketamine in the developing world was administered to a convenience sample of missionary physicians. Descriptive statistics are reported. Results: Of the 172 surveyed physicians, 122 (71%) responded;55 reported experience with ketamine. These physicians estimated a total of 12,844 administrations. The format of one procedural physician and a second trained anesthesiologist/anesthetist was unavailable in the practice of 59% of the responding physicians, and 34% routinely performed procedures while simultaneously supervising ketamine administration and monitoring its clinical effect. Pulse oximetry was used ''often'' or ''always'' by only 10% of the physicians. Cardiac monitoring and intermittent vital signs were used in only 19% and 45%, respectively. One unexplained pediatric death occurred during an unmonitored, unobserved ward recovery. An adult suffered cardiac arrest after a failedintubation attempt. Seventeen other complications possibly related toketamine were apnea (n = 10), laryngospasm (n = 6), and aspiration (n= 1), all of which were transient and without sequelae. Physicians believed that recovery hallucinations and agitation were frequent in adults and unusual in children. Conclusions: Death and other serious complications were rare in this survey reporting >12,000 estimated ketamine administrations in the developing world. Although the limitations ofsurvey data are recognized, the margin of safety with ketamine appears to be high, even when administered by non-anesthesiologists in settings lacking basic mechanical monitoring. These findings have importantimplications for the use of ketamine outside the controlled operatingroom environment in developed countries.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 20:08:13