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July 6, 2022

If a patient is given pre hospital Ketamine, would you answer the question in the clinical tab, yes to chemically sedated, I would like to ask the same question for chemically paralyzed if such medication is given such as Rocuronium? There has been discussion that these drugs do not stay in the patients system for very long.

The PTOS Manual provides examples of common paralyzing drugs under the Paralyzing Drugs data element. Rocuronium is included within these examples. Under GCS qualifiers, I recommend Rocuronium be recorded as a paralyzing drug and Ketamine be recorded under sedation. Note that each of these agents has a slightly different duration of action (as you mention), so their effect on the GCS depends on when they were given. You will only record Chemically Sedated or Chemically Paralyzed as a “yes” for the GCS Qualifiers data element if the drug was affecting the patient at the time the GCS score recorded was assessed. You will need to work with your trauma program to make that determination.

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