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Ketamine analgesia — DipIMC MCQ

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HardPre-Hospital PharmacologyKetamine analgesiaDipIMC

A 30-year-old with a mangled lower limb is haemodynamically stable but has severe pain despite splinting. Entonox is ineffective. What is the most appropriate drug/dose?

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

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Correct answer: AKetamine analgesia according to local pre-hospital protocol

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

E is correct: Ketamine can provide effective analgesia for severe trauma pain while preserving airway reflexes when used within protocol. A is less suitable because rapid IV benzodiazepine bolus carries avoidable respiratory risk; B is less suitable because the dose is below standard severe adult asthma nebuliser dosing; C is less suitable because analgesia is important but does not replace the first physiological intervention; D is less suitable because it is a common auto-injector dose rather than the adult healthcare dose. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Medicines Guidelines; Resuscitation Council UK; BNF