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Ketamine analgesia — DipIMC MCQ

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ModeratePre-hospital PharmacologyKetamine analgesiaDipIMC

A 70 kg adult with severe traumatic pain from a femoral fracture remains haemodynamically stable after initial splinting. Intravenous access is available and opioid has caused nausea previously. What is the most appropriate drug/dose?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Ketamine in analgesic dose titrated intravenously according to local protocol

Analgesic-dose ketamine can be useful for severe trauma pain when used by trained clinicians with monitoring and local governance. Induction-dose ketamine is for anaesthesia/RSI contexts and can cause avoidable adverse effects if used as simple analgesia. Sedatives do not provide analgesia and can compromise airway. The pearl is to distinguish analgesic, dissociative and induction dosing.

Reference: JRCALC Guidelines 2025; NICE Major Trauma NG39