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BACKGROUND Ketamine has many unique attributes making it well suited to certain applications in the emergency department (ED), including pediatric procedural sedation, and as an induction agent in patients with asthma and ex acerbation of chronic obstructive pulmonary disease. However, ketamine has been historically contraindicated for induction use in patients with head injury because of a concern that it may increase intracranial pressure (ICP). The most recent edition of Tintinalli and colleague’s Emergency Medicine 1 states that ketamine “should be avoided in patients with closed head injuries.” There have been 2 more recent review articles on this topic challenging this myth. 2,3

Myth: Ketamine should not be used as an induction agent for intubation in patients with head injury