Ketamine analgesia — DipIMC MCQ

Correct answer: E — Titrated ketamine analgesia according to local protocol

Option E is correct because Ketamine in analgesic doses is appropriate for severe traumatic pain when opioids are unsuitable or access is limited, with monitoring of airway, observations and psychological emergence effects. Immediate RSI is disproportionate in an awake patient maintaining airway and ventilation. The key pearl is that analgesia is part of resuscitation, but it must be titrated to effect rather than given as a fixed sedating bolus. Option D is less appropriate because that dose is an ALS cardiac-arrest dose and is unsafe for this non-arrest indication; option C is less appropriate because aspirin is useful in ACS but inappropriate for this presentation. Option A is less appropriate because untitrated opioid dosing can cause avoidable hypotension or respiratory depression; option B is less appropriate because steroids have delayed onset and should not replace the immediate treatment. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: NICE Major Trauma NG39; JRCALC Guidelines; ATACC