Personally, I’d take ketamine over fentanyl in most trauma situations. Keeps the blood pressure up better from what I’ve seen, and patients seem to tolerate it well.

I’ve run both in the field. Fentanyl is great for pain, but ketamine gives you more flexibility when the patient is really banged up.

Honestly, ketamine was a game changer for our service. Less worry about respiratory depression compared to opioids.

For me, fentanyl still has a place. Not every trauma patient needs to be dissociated into another dimension.

YMMV, but ketamine has worked way better for severe trauma cases where the patient is agitated and in a ton of pain.

Not gonna lie, I prefer fentanyl for isolated fractures. Smooth pain control without some of the weird reactions I’ve seen with ketamine.

I’ve seen ketamine save a lot of headaches during extrications. Patients stay calmer and procedures get easier.

Mileage may vary, but fentanyl is more predictable for me. Ketamine can be awesome or kinda messy depending on the patient.

Experienced medic here. If they’re hypotensive, ketamine usually gets my vote.

As a newer EMT, ketamine seemed intimidating at first, but after seeing it used a few times I’m a lot more comfortable with it.

Wouldn’t say one is always better. Different tools for different jobs.

I’ve run it before on multiple trauma calls. Results were solid and airway issues were less of a concern.

Honestly, ketamine all day for major trauma. The safety profile in those situations is hard to ignore.

Didn’t do much for me as far as preference goes. Both drugs work when used appropriately.

I’ve had a couple patients get pretty dysphoric coming off ketamine. Not the end of the world, but worth mentioning.

I’ve been in EMS over a decade. The more experience I get, the more I appreciate ketamine for serious trauma.

Both have pros and cons. If I had to pick one for a critical trauma patient, I’d probably lean ketamine, but context matters.