What is the ketamine dose in adult continued severe pain management and its max total?

• A. 5 mg/kg
• B. 50 mg IV; max 150 mg
• C. 25 mg IV/IO/IM; may repeat 2x; max total 75 mg
• D. 100 mg IV; max 300 mg

Answer: (C)

In this adult continued severe pain scenario, ketamine is given in small, fixed boluses rather than weight-based dosing, with a strict maximum total. The standard approach is 25 mg delivered IV, IO, or IM, and you may repeat that dose up to two times. This yields a maximum total of 75 mg. The goal is to provide rapid analgesia while keeping the total exposure low to reduce risks such as excessive sedation, dissociation, or airway/hemodynamic issues. The routes allowed (IV, IO, IM) offer flexibility in urgent care settings.

Other options don't fit because they either rely on weight-based dosing, propose higher single-dose amounts, or set a total that isn’t consistent with the controlled, incremental analgesic strategy described above.