Guide
This guide has 2 sections. The first explains how to prepare the shot and the second explains how to administer it.
Ideally, pharmaceutical grade ketamine solution in sterile vials should be used, although those can be hard to obtain. For this reason, the guide assumes the user only has access to street bought Ketamine and walk them through how to make a solution out of it and prepare a shot in the cleanest way possible.
It is highly recommended to only used high purity ketamine for IM use. Some adulterants might not get absorbed and result in infections and/or the formation of abscesses. I cannot stress how important it is to regularly test your ketamine, even if you're getting it from a trusted source.
Materials
- Ketamine
- 1x Sterile disposable syringe > 1ml syringes work, 2ml syringes are ideal.
- 2x Sterile disposable needles (1x pull-up needle and 1x administration needle).
> You will need one needle to prepare your solution and one to administer the shot. Do not use the same needle for both. Needle gauges don't really matter, needle length however does; I use a 1 inch 21g needle to prepare my shots and a 1.5 inch 23g needle to administer them.
- 0.9% NaCl Saline solution > You will need ~1ml per 100mg of ketamine.
- Milligram scale (0.001g)
- 70% alcohol solution
- Bandages (kitchen paper would be second best)
- Cotton
> 0.3 micron filters are safer; I’ve found regular cotton to be more than adequate.
- Metal spoon
- (optional) Plasters. Bandages and medical tape also work.
Preparing your shot.
- Make sure you have all the materials you need ready.
- Wash your hands thoroughly with soap and warm water.
- Use a small piece of gauze/ bandage soaked in 70% alcohol to disinfect the bowl of spoon. Once the whole surface has been swabbed, wait for 30 seconds and make sure all the alcohol has evaporated. Any excess unevaporated alcohol can be burned off with a lighter
The most effective way would be to swab the spoon in parallel lines from the tip to the stem of the spoon. The entire surface should be exposed to the alcohol and no visible dirt should be left on the surface.
- Weigh out your dose of ketamine while waiting for the alcohol to evaporate. Ketamine doses are weight dependent and the average K-hole dose is 100mg. Consult online resources such as erowid or tripsitme to determine your dose depending on your desired effect. Rule of thumb is you will need 50% of what you would normally snort.
Once youve weighed out your dose, try and crush the ketamine into as fine a powder as possible, it will save you a lot of trouble when trying to make the ketamine solution.
- Remove the syringe and pull-up needle from their packaging. Assemble the needle onto the syringe.
- Assuming there is no alcohol in your spoon, empty your ketamine powder into the spoon. Use your syringe to add 1ml of 0.9% saline per 100mg of ketamine to the spoon.
If you're going to inject 50mg of ketamine, add 0,5 ml of saline. If you're going to inject 150mg of ketamine, add 1.5ml of saline and so on.
- Gently use the pull-up syringe to mix the ketamine into the saline, until you don't see any solids in the solution anymore.
You can use the needle to crush any ketamine crystals that are still visible (larger gauge needles makes this easier). Any undissolved particles will be filtered out in the next step.
- Wash your hands (yes, again). Get a small amount of cotton and roll it into a ball; slightly larger than a matchstick head work fine, but if in doubt larger is better than smaller. Put it into your solution in the spoon, put the needle tip on it and draw your solution up into the syringe.
- Remove the pull up needle from your syringe and put the actual administration needle onto the syringe. Put the cap on the pull up needle and dispose of it safely.
- Voila! Your ketamine shot is now ready for administration!
Administering your shot
- Choosing the injection site: The 3 most common sites for intramuscular injections are (1) your deltoid muscle, (2) your gluteal muscle and (3) your thigh muscle; please google these and make sure you've identified these before proceeding. (1) is probably the easiest, but you’ll be doing the whole thing one handed. I was always taught to avoid (2); although it is one of the largest muscles you can inject into, there is a relatively high risk of hitting a blood vessel - this is something you really want to avoid. Personally, I always go for (3), the thigh muscle; that’s the one I will be explaining how to hit in this guide. Note that this is actually a collection of muscles. Your target is the vastus lateralis (google images save lives). To identify it, sit down on a chair with your legs bent. Raise and straighten the target leg in front of you and the muscle standing out on the outside of your upper leg is the one you want to hit. You'll want to inject in the middle of it; a guide to identifying it and injecting it can be found here.
You can determine your injection site by drawing a 3x3 grid on the front side of your thigh. If you're injecting into your right leg, the injection side will be in the cell on the right side in the middle row.
- Before injecting, find a safe place to administer your shot. The effects can kick in pretty fast and you don't want to fall and injure yourself if you k-hole.
At the time of and during the injection, the muscle should be relaxed as much as possible. The first couple of times this might be hard, but after doing it a couple of times it gets easier.
- Wash your hands
If you used soap and water earlier, you can rinse your hands with 70% alcohol this time.
- Use a generous amount of 70% alcohol to disinfect the injection site. You can use a soaked bandage to rub the alcohol around. Wait 30 seconds for the alcohol to kill any bacteria.
- Remove the cap from the needle and hold the syringe in your dominant hand. Do NOT touch anything with the needle.
- Fully relax the target muscle. It has to remain relaxed until you've pulled the needle out.
notice the muscle will slip to the side of where it was when you tensed it up while trying to locate it.
- If you want to be super efficient you can use the Z track method. This video provides a good illustration of what this is and how to do it.
- Gently insert the needle into the muscle in one single fluid motion.
The faster the better, the slower the more painful. Make sure you get it deep enough; the needle doesn't have to go all the way in, but it does have to be inside the muscle. Exactly how deep it should go heavily depends on the amount of fat there is under the skin; 2-3cm should work for the average adult. Ideally, you get it to the dead center of the belly of the muscle. Too deep and you might be injecting it between muscles or against bone, too shallow and you will be administering under your skin. It might take some practice.
- Aspirate: pull back on the plunger lightly. If nothing happens, proceed to the next step. If blood shoots into the syringe, the needle is in a blood vessel. If this happens, pull out the needle slowly and apply pressure.
- Assuming you’re in the right spot, have not aspirated any blood and the muscle is still relaxed, slowly press down the plunger. Do not rush this part.
It is perfectly normal to press down the plunger over 30 seconds; but I would not take more than 60 seconds.. Rule of thumb is slower is better than faster. Too fast and it will hurt. Too slow and you might start feeling the effects of the ketamine before you manage to pull the needle out.
- Once the entire shot (or however much you feel comfortable injecting) is done, pull out the needle in one fluid motion. This is something you don't want to do slowly.
- Cap the needle and dispose of it.
- Apply a plaster or bandage with tape to the site of injection, sometimes a little blood might leak out of it. Sometimes you might not even find the hole, in which case don't worry about it.
- You have about 5 minutes before you start feeling the effects, so go sit/ lie down in a safe place where you won't injure yourself if you lose your balance or k-hole. If the injection site hurts, gently rub it with your hand; although this is a bit redundant because you will shortly be anaesthetised.
