Patient Outcomes Following Ketamine Administration for Acute Agitation with a Decreased Dosing Protocol in the Prehospital Setting

• DOI: 10.1017/s1049023x21000236
• Publication Date: 2021-03-08T08:16:18Z
• Authors: Cassidy Cunningham; Karen Gross; John P. Broach; Laurel O’Connor
• Keywords: Demographics

Abstract Background: Agitated behaviors are frequently encountered in the prehospital setting and require emergent treatment to prevent harm patients personnel. Chemical sedation with ketamine works faster than traditional pharmacologic agents, though it has a higher incidence of adverse events, including intubation. Outcomes following varying initial doses intramuscular (IM) use have been incompletely described. Objective: To determine whether using lower dose IM protocol for agitation is associated more favorable outcomes. Methods: This study was pre-/post-intervention retrospective chart review care reports (PCRs). Adult who received chemical form agitated were included. Patients divided into two cohorts based on standard 4mg/kg 3mg/kg option an additional 1mg/kg if required. Primary outcomes included intubation hospital admission. Secondary emergency department (ED) length stay, or physical restraints, assaults ED employees, documented events. Results: The cohort consisted 211 patients. 81 patients, 17 whom supplemental administration. Demographics did not significantly differ between (mean age 35.14 versus 35.65 years; P = .484; 67.8% 65.4% male; .89). Lower subjects administered 3.24mg/kg) compared 3.51mg/kg). There no statistically significant difference rate (14.2% 18.5%; .455), stay (14.31 14.88 hours; .118), need restraint (P .787), admission (26.1% 25.9%; .677). In cohort, 41.2% (7/17) intubated, this receive (8/64, 12.5%; <.01). Conclusion: Access effective, fast-acting paramount providers. No differences existed when implemented sedation. second had increase rate. A may be considered limit amount medication population high-risk