Emergency Department Presentation of Ketamine Abusers in Hong Kong: a Review of 233 Cases

Objectives: To study the acute clinical presentations of ketamine abusers in Hong Kong.

Design: Retrospective chart review.

Setting: Fifteen accident and emergency departments in Hong Kong.

Patients: Consultations associated with recent ketamine use either confirmed by history or urine test were searched for from the database of the Hospital Authority Hong Kong Poison Information Centre from 1 July 2005 to 30 June 2008. Their medical records and investigation results were analysed.

Results: A total of 233 records of ketamine use were included for review. Patient ages ranged from 13 to 60, with a median of 22 years, and the male-to-female ratio being 2.1:1. The most common symptoms of ketamine misuse were impaired consciousness (45%), abdominal pain (21%), lower urinary tract symptoms (12%), and dizziness (12%). The most common abnormal physical findings were high blood pressure (40%), followed by tachycardia (39%), abdominal tenderness (18%), and white powder in the nostrils (17%).

Conclusion: Most ketamine abusers presented acutely with transient central nervous system depression, abdominal pain, or lower urinary tract symptoms. Clinicians should be alert to the typical age-group, signs and symptoms of such abusers presenting in an acute medical setting.