This session explores the emerging role of ketamine in the management of benzodiazepine-refractory status epilepticus (BRSE) in the prehospital setting. Learners will review seizure pathophysiology, examine why benzodiazepines sometimes fail, and understand the mechanism of NMDA receptor antagonism. Through real-world data and case studies, the presentation emphasizes early, aggressive seizure termination, evidence for ketamine's effectiveness, and the importance of airway monitoring during its use.
Learning Objectives:
1. Recognize when status epilepticus becomes benzodiazepine-refractory and the importance of timely, escalated treatment.
2. Describe the mechanism of action of ketamine and how it addresses receptor changes in prolonged seizures.
3. Apply evidence-based dosing and airway management strategies when using ketamine in the prehospital setting.
Presenter Biography:
Dr. William Heuser is a board-certified critical care and nutrition support pharmacist, paramedic, and flight paramedic with extensive experience in emergency and critical care medicine. With a background in clinical pharmacology and toxicology, he has worked in high-acuity environments, including emergency departments, intensive care units, and pre-hospital flight medicine. Dr. Heuser has served as a clinical pharmacist in tertiary academic teaching hospitals, taught physiology and pharmacology as a professor, and contributed to toxicology fellowship programs. His research interests include hemodynamic optimization, resuscitation pharmacotherapy, and shock management, with multiple publications in critical care and emergency medicine. He is a respected educator, mentor, and speaker, known for his expertise in vasopressor and inotrope therapy, as well as his practical, real-world approach to high-stakes patient care.
ALS/BLS: Core - Pharma