Ketamine in US EMS protocols
Includes 4 agencies outside the US.
| Indication | Spread: box is the middle half, dot means most agree | Range |
|---|---|---|
| Agitation Adult | 100 to 300 mg median 250, n=13 | |
| Adult, weight-based | 1 to 5 mg/kg median 2.75, n=78 | |
| Pediatric, weight-based | 1 to 4 mg/kg median 2, n=35 | |
| Asthma / bronchospasm Adult, weight-based | 0.25 to 0.5 mg/kg median 0.5, n=5 | |
| Bradycardia Adult, weight-based | Most use 1 mg/kg range 0.5 to 3 mg/kg, n=5 | |
| Cardiac arrest Adult, weight-based | Most use 1 mg/kg range 0.5 to 3 mg/kg, n=5 | |
| Hyperactive delirium Adult, weight-based | 2 to 5 mg/kg median 4, n=32 | |
| Pediatric, weight-based | 1.5 to 5 mg/kg median 3, n=17 | |
| Other Adult | 25 to 150 mg median 50, n=19 | |
| Adult, weight-based | 0.5 to 3 mg/kg median 1.5, n=92 | |
| Pediatric, weight-based | 0.4 to 3 mg/kg median 1.1, n=70 | |
| Mild to moderate pain Adult | 10 to 40 mg median 18.75, n=31 | |
| Adult, weight-based | 0.1 to 0.5 mg/kg median 0.25, n=112 | |
| Pediatric, weight-based | 0.1 to 0.5 mg/kg median 0.275, n=86 | |
| Severe pain Adult, weight-based | 0.1 to 0.5 mg/kg median 0.3, n=30 | |
| Pediatric, weight-based | 0.1 to 0.45 mg/kg median 0.3, n=23 | |
| Post-intubation sedation Adult | 100 to 200 mg median 100, n=5 | |
| Adult, weight-based | 0.4 to 3 mg/kg median 1, n=43 | |
| Pediatric, weight-based | 0.5 to 3 mg/kg median 1, n=23 | |
| Procedural sedation Adult | 50 to 300 mg median 100, n=11 | |
| Adult, weight-based | 0.5 to 3 mg/kg median 1, n=50 | |
| Pediatric, weight-based | 0.5 to 3 mg/kg median 1, n=44 | |
| RSI induction Adult | All use 200 mg n=5 | |
| Adult, weight-based | 1 to 3 mg/kg median 2, n=97 | |
| Pediatric, weight-based | 1 to 3 mg/kg median 2, n=69 | |
| Seizure Adult | All use 100 mg n=11 | |
| Adult, weight-based | 1 to 3 mg/kg median 1.5, n=18 | |
| Pediatric, weight-based | 1 to 2 mg/kg median 1, n=21 |
Too few protocols to chart yet (protocols in brackets): ACS / chest pain (2), Atrial fibrillation with RVR (1), Eclampsia / pre-eclampsia (1), Head injury / TBI (1), Hypotension / shock (2), Post-ROSC care (1), Respiratory distress (2), Status epilepticus (2), SVT (2), Narrow-complex tachycardia (2), Wide-complex tachycardia (1), Trauma / hemorrhage (1), VF / pulseless VT (1)
Doses far off from what other protocols give are likely misreads, so they are left out until checked. How that works.
Named agencies with a page170
Agencies whose protocols are a public record are named here. Their own doses are on their own pages; this list carries no values.
- Academy of Medicine of Cincinnati
- Ada County-City Emergency Services System
- Adams, Benton, Franklin, Yakima Counties
- Alabama Department of Public Health Office of Emergency Medical Services
- Ambulance Victoria
- Anderson County Emergency Medical Services
- Annaville Fire Department
- Arizona Department of Health Services
- Arlington EMS System
- Ashwaubenon Public Safety, Howard Fire Rescue, & De Pere Fire Rescue
- BC Emergency Health Services
- Benbrook Fire Department
- Berkeley County EMS
- Berrien County Medical Control Authority
- BEST EMS
- Bexar County ESD 4 Fire Rescue
- Bonner County Emergency Medical Services
- Boulder County Protocol Committee
- Brilliant Fire Department
- Brownsville Rural Fire District, Halsey-Shedd Fire Protection District, Jefferson Fire District, Lebanon Fire District, Scio Fire District & Sweet Home Fire & Ambulance District
- Brunswick County EMS
- Cabarrus County EMS
- Calhoun County EMS System
- Campbell County Emergency Medical Service
- Central Arizona Regional EMS
- Central California Emergency Medical Services
- Charleston County EMS
- Chaves County EMS
- Chelan/Douglas/Okanogan/Grant County
- City of Austin / Austin-Travis County EMS System
- Clark County EMS System
- Clark County EMS (Washington)
- Confederated Tribes of Grand Ronde Department of Emergency Services
- Coos County Emergency Medical Services
- County of San Diego Emergency Medical Services
- Cowlitz County EMS Council
- Craven, Jones, Pamlico Counties EMS
- Dane County EMS System
- Davidson County Emergency Services
- Daviess County EMS
- DC Fire and EMS
- Denver Health Paramedic Division
- Department of Aviation Medicine
- Dorchester County EMS
- East Baton Rouge Parish Department of Emergency Medical Services
- El Campo Emergency Medical Service
- EMS Region VII Bioterrorism and All Hazards Preparedness Committee
- Escambia County Emergency Medical Services
- Evansville Fire Department
- Fairfax County Fire and Rescue Department
- Fern Creek Fire and Emergency Medical Services
- FirstHealth of the Carolinas
- Fort Lauderdale Fire Rescue
- Fort Worth Regional EMS System
- Franklin County Emergency Medical Services
- Galveston Area Ambulance Authority
- Giles County EMS
- Grant County
- Greater Elgin Area EMS System
- Greenville County Emergency Medical Services
- Hays County ESD 9 EMS
- Haywood County EMS System
- Hunt County EMS
- Idaho EMS Physician Commission
- Illinois Region VIII Emergency Medical Services
- Inland Counties Emergency Medical Agency
- Iowa County Ambulance Service
- Kentucky Board of Emergency Medical Services
- Kern County Public Health
- Kosciusko County Paramedics
- La Porte County Emergency Medical Service
- Lake County Emergency Medical System
- Lake Emergency Medical System
- Lane County Medical Control Board
- Laurens County Emergency Medical Services
- Levy County Department of Public Safety
- Lincoln County EMS
- Louisville Metro EMS
- Maine Emergency Medical Services
- Manatee County Emergency Medical Services
- Marion County
- Maryland Institute for Emergency Medical Services Systems
- Massachusetts Office of Emergency Medical Services
- Mauston Area Ambulance
- McKinney Fire Department
- MEP (Medical Emergency Partnership) in partnership with SSM Health
- MetroCare Services and Abilene Fire Department
- Michigan Department of Health and Human Services
- Michigan Department of Health and Human Services (MDHHS) / Midland Gladwin MCA
- Michigan Department of Health and Human Services (MDHHS) / West Michigan Regional MCC
- Ministry of Health, Emergency Health Regulatory and Accountability Branch
- Miramar Fire Rescue Department
- Montana Board of Medical Examiners
- Montgomery County Hospital District
- Mountain West Ambulance
- Muskegon County
- Nash County Emergency Medical Services
- National Emergency Medical Services
- Nebraska Medicine Division of Prehospital and Emergency Medical Services
- Nevada EMS Program
- New Hampshire Bureau of Emergency Medical Services
- New Jersey Department of Health
- New York State Department of Health, Bureau of Emergency Medical Services and Trauma Systems
- North Carolina Office of Emergency Medical Services (NC OEMS)
- North Central Oregon EMS Agencies
- Northeast Ohio Regional EMS Protocol Committee
- Northeastern Montana Stat Air Ambulance Cooperative
- Northwest Arkansas Regional EMS
- Northwest Community EMS System
- Northwest Region Emergency Medical Services & Trauma Care Council
- Norton Sound Health Corporation
- Nueces County ESD4
- Oakland County Medical Control Authority
- Ocala/Marion County/The Villages Public Safety EMS
- OCEMS
- Okaloosa County EMS
- Old Dominion EMS Alliance, Inc.
- Osage Ambulance District
- Palm Beach Gardens Fire Rescue
- Pend Oreille County Emergency Medical Services
- Peninsulas EMS Council, Inc.
- Pennsylvania Department of Health, Bureau of Emergency Medical Services
- Peoria Area EMS System
- Pettis County Ambulance District
- Queensland Ambulance Service
- Rappahannock EMS Council
- Region 1 Emergency Medical Services
- Region 4 EMS
- Region One Metropolitan Ambulance Council
- Region One Metropolitan Ambulance Council (MAC)
- Region X EMS
- Regional Emergency Medical Advisory Committee of New York City
- REMSA
- REMSA Sioux Falls
- Reno County Emergency Medical Services
- Rhode Island Department of Health – Center for Emergency Medical Services
- County of Riverside EMS Agency
- Routt County EMS
- Rowan County Emergency Services EMS Division
- Salem Fire Department
- Salt Lake County EMS
- Santa Barbara County Public Health Department
- Sierra – Sacramento Valley EMS Agency
- South Carolina Department of Public Health (DPH) Division of EMS
- South Plains Emergency Medical Services
- Southern Fox Valley EMS System
- Spokane County EMS
- St. Johns County Fire Rescue
- Stanislaus County Emergency Medical Services Agency
- Stanly County EMS
- State Board of Emergency Medical, Fire, and Transportation Services
- State of Nebraska
- Stevens County Emergency Medical Services
- Susquehanna Regional EMS
- Tennessee Emergency Medical Services
- The Williamson County EMS System
- Three Rivers Ambulance Authority & Fort Wayne Fire Department
- Thurston County Medic One
- Tidewater Emergency Medical Services Council, Inc.
- Tippecanoe Emergency Ambulance Service
- Tri-County Emergency Medical Control Authority
- Tri County Emergency Medical Services, Inc.
- Utah Department of Public Safety, Bureau of Emergency Medical Services
- UTSW/Parkland BioTel EMS System
- Vermont Department of Health
- Washington County Emergency Medical Services
- Weber County Paramedic Program
- West Virginia Department of Health, Office of Emergency Medical Services
- Wilson County Emergency Management Agency
- Wilson County ESD #4
Cite this
United States EMS Protocol Census, Ketamine: n=209 protocols from 174 named agencies / 48 states, as of 2026-10-31