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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, August 30, 2021

Agitation Control With Ketamine

REBEL EM - August 30, 2021 - By Muhammad Durrani
Paper: Barbic D et al. Rapid Agitation Control With Ketamine in the Emergency Department: A Blinded, Randomized Controlled Trial. Ann Emerg Med. 2021. PMID: 34353650
Clinical Question: Does ketamine 5mg/kg IM or midazolam 5mg plus haloperidol 5mg IM result in more rapid sedation of acutely agitated patients in the ED?
Author Conclusion: 
“Ketamine achieves faster sedation of severely agitated ED patients while maintaining a similar safety profile.”
Clinical Take Home Point:
In this small randomized clinical trial of patients with severe psychomotor agitation, the use of ketamine was associated with a significantly shorter time to adequate sedation versus a combination of midazolam and haloperidol. The findings need to be interpreted in the context of an inadequate number of enrolled patients, early termination of the trial, and single center setting.
The bottom line is that the use of ketamine appears to be a safe and attractive alternative with a good safety profile for severe psychomotor agitation in the emergency department.