A pre-hospital clinician is considering the use of ketamine for a patient with raised intracranial pressure. Historically, ketamine was considered con...

Question

A pre-hospital clinician is considering the use of ketamine for a patient with raised intracranial pressure. Historically, ketamine was considered contraindicated in this situation. What is the current evidence-based position?

Accepted Answer

Ketamine is now considered safe in patients with raised ICP - the historical concern about ICP elevation has been disproven; ketamine's haemodynamic stability makes it preferable to agents that cause hypotension

Answer

Ketamine directly reduces ICP and should be the first-line agent for this reason alone

Answer

Ketamine remains absolutely contraindicated in raised ICP

Answer

Ketamine has no effect on ICP whatsoever

Answer

Ketamine can only be used in raised ICP if co-administered with thiopentone

uk-dipimc MCQ (SBA): Ketamine and Raised ICP

A pre-hospital clinician is considering the use of ketamine for a patient with raised intracranial pressure. Historically, ketamine was considered contraindicated in this situation. What is the current evidence-based position?