Ketamine Pilot Study
Rattlesnake Envenomation
About this trial
This is an interventional treatment trial for Rattlesnake Envenomation focused on measuring Acute pain after rattlesnake bite, Rattlesnake envenomation, low dose ketamine, pain dose ketamine
Eligibility Criteria
Inclusion Criteria:
- Ages ≥ 18 years.
- Able to speak and understand English.
- RSE requiring IV pain medication for NRS pain score > 5.
- No allergy to ketamine or fentanyl.
- Ability to provide informed consent.
- ≤ 24 hours from envenomation.
Exclusion Criteria:
- Pregnant or lactating.
- Prisoners.
- Refugees.
- History of schizophrenia.
- Clinically intoxicated.
- On buprenorphine therapy.
- History of uncontrolled hypertension
- Increased intracranial pressure
- Systemic envenomation
Sites / Locations
- Banner - University Medical Center, Phoenix campus
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Fentanyl
Ketamine
Drug administration: A single dose of fentanyl 1mcg/kg IV, maximum 100 mcg, over 15 minutes. Time drug given will be documented Data obtained prior to med administration and then following medication administration at intervals of 15, 30, 60 and 120 minutes Record vital signs (HR, B/P, resp rate, O2 sat) Obtain and assess pain response scores Pain Numerical Rating Score (NRS - 0-10) Richmond Agitation Sedation Scale (RASS) Side Effect Rating Scale for Dissociative Anesthesia (SERSDA) Record any airway interventions required? If yes what? new supplemental O2/BVM/intubation, jaw thrust Record any rescue meds, dose and time (Rescue medication - Fentanyl): 1 mcg/kg IV fentanyl (0.5 mcg/kg if age >55 yrs) Defined as rescue if given <30 min post study intervention for pain score >5 or patient requesting additional medication. Patient pain satisfaction score at discharge
Drug administration: A single dose of ketamine 0.3 mg/kg IV over 15 minutes. Time drug given will be documented Data obtained prior to med administration and then following medication administration at intervals of 15, 30, 60 and 120 minutes Record vital signs (HR, B/P, resp rate, O2 sat) Obtain and assess pain response scores Pain Numerical Rating Score (NRS - 0-10) Richmond Agitation Sedation Scale (RASS) Side Effect Rating Scale for Dissociative Anesthesia (SERSDA) Record any airway interventions required? If yes what? new supplemental O2/BVM/intubation, jaw thrust Record any rescue meds, dose and time (Rescue medication - Fentanyl): 1 mcg/kg IV fentanyl (0.5 mcg/kg if age >55 yrs) Defined as rescue if given <30 min post study intervention for pain score >5 or patient requesting additional medication. Patient pain satisfaction score at discharge