Prehospital Analgesia With Intra-Nasal Ketamine

• Status: Completed
• Trial end date: 2018-05-24
• Target enrollment: 0
• Participant gender: All

Summary

Acute painful conditions make-up a large proportion of pre-hospital transports in British Columbia (BC) yet Basic Life Support (BLS) paramedics have limited options to provide analgesia and therefore adequate and timely pain relief is often significantly delayed.

Inhaled nitrous oxide is commonly used as a pre-hospital analgesic and is considered "usual care" for pre-hospital providers in BC, but its utility in severe pain is uncertain. Moreover, nitrous oxide is limited in its effectiveness by a short duration of action, nausea, vomiting, and the necessity for patient cooperation.

IN Ketamine has been shown to provide rapid, easily-administered, and well-tolerated analgesia in many settings. The investigators believe that the addition of IN ketamine to usual care with nitrous oxide inhalation for adults experiencing moderate to severe intensity acute pain in the pre-hospital setting will result in improved pain severity, improved patient-reported comfort, and improved patient satisfaction.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of British Columbia
• Collaborator: British Columbia Emergency Health Services
• Treatments: Ketamine

Criteria

Inclusion Criteria:

• Patients who have an acute painful condition, as determined by the Emergency Health Services attendant

• A pain score of 5 or greater (signifying moderate or severe pain)

• Desire for analgesia when queried.

Exclusion Criteria:

• Less than 18 years of age.

• Previous hypersensitivity, intolerance or allergy to ketamine

• Chest pain

• Altered mental status

• Inability self-report pain score

• Pregnancy

• Nasal occlusion

• Systolic Blood Pressure < 90 mm Hg

• Requiring immediate attention of the paramedic

• Ineligible to receive inhaled nitrous oxide as per BC EHS protocols