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JOURNAL ARTICLE

Ketamine as a first-line treatment for severely agitated emergency department patients

Jeff Riddell, Alexander Tran, Rimon Bengiamin, Gregory W Hendey, Patil Armenian
American Journal of Emergency Medicine 2017 February 13
28237385

OBJECTIVE: Emergency physicians often need to control agitated patients who present a danger to themselves and hospital personnel. Commonly used medications have limitations. Our primary objective was to compare the time to a defined reduction in agitation scores for ketamine versus benzodiazepines and haloperidol, alone or in combination. Our secondary objectives were to compare rates of medication redosing, vital sign changes, and adverse events in the different treatment groups.

METHODS: We conducted a single-center, prospective, observational study examining agitation levels in acutely agitated emergency department patients between the ages of 18 and 65 who required sedation medication for acute agitation. Providers measured agitation levels on a previously validated 6-point sedation scale at 0-, 5-, 10-, and 15-min after receiving sedation. We also assessed the incidence of adverse events, repeat or rescue medication dosing, and changes in vital signs.

RESULTS: 106 patients were enrolled and 98 met eligibility criteria. There was no significant difference between groups in initial agitation scores. Based on agitation scores, more patients in the ketamine group were no longer agitated than the other medication groups at 5-, 10-, and 15-min after receiving medication. Patients receiving ketamine had similar rates of redosing, changes in vital signs, and adverse events to the other groups.

CONCLUSION: In highly agitated and violent emergency department patients, significantly fewer patients receiving ketamine as a first line sedating agent were agitated at 5-, 10-, and 15-min. Ketamine appears to be faster at controlling agitation than standard emergency department medications.

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Arnaud Depil Duval wrote:

4

Which dose did you use ?

Pedro Lito wrote:

0

Please send me this papper please!!
Pedrolito@fcsaude.ubi.pt

Julio Cezar Santos wrote:

0

Please could you send to me this paper please??? Thank's

Parviz Azad wrote:

0

Which doses did you use?

Claudia Reyna wrote:

0

Please send me this paper claudiareyna0405@gmail.com thanks!

Nicolás Loncar wrote:

0

Please send me this paper nicolasloncar@gmail.com

Julio Neves wrote:

0

Please send the paper to flagsnow@gmail.com

Miguel Achega wrote:

0

Can someone send me this paper?
miguelachega@gmail.com

Nehuén Carbajal wrote:

0

Please send me guía article: nehuen_89@hotmail.com

Katia Cazzola wrote:

-1

Please send me the article. Katiab.cazzola@gmail.com
Thank you

Ana Fonseca wrote:

-2

Please send me this article: anappratasfonseca@gmail.com

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