BSO Protocols Practice Test

In adult chemical restraint, the aim is rapid, controllable calming while keeping the airway protected. Ketamine dosing is weight-based and given in increments, but there is a safety ceiling to prevent excessive sedation and airway compromise.

A commonly used maximum total dose for an adult is 800 mg. This cap helps minimize risks such as respiratory depression, airway obstruction, prolonged recovery, and emergence phenomena that become more likely if the cumulative amount administered is too high. In practice, you might start with an initial ketamine dose (for example, IM around 4–5 mg/kg or IV around 1–2 mg/kg) and may repeat dosing if needed, but you should not exceed the 800 mg total within that intervention to maintain safety.

Doses well below this cap can be insufficient for some agitated patients, while doses above it increase the likelihood of adverse effects, which is why 800 mg is referenced as the maximum in many protocols.