SDN Members don't see this ad. (About Ads) As an update to this topic, some may find the article by Jennings et al in this months annals of EM interesting. It compares prehospital pain management by paramedics with morphine only or morphine + ketamine. As you would suspect, the morphine + ketamine group had significantly greater pain reduction. There was also increased side effects with that group, however they were minor in nature. Both groups started with 5mg morphine (and sometimes methoxyflurane also) and then received additional medication titrated to pain. The morphine group got an average of 14mg and the ketamine group 40mg. It seems both treatment arms were more aggressive than typically allowed prehospital, with redosing at 5min and 3min intervals respectively.