Ketamine for Acute Agitation
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Purpose of Review
This review describes the use of ketamine for acutely agitated patients in the emergency care setting. Evidence for its efficacy will be reviewed and practical suggestions for using ketamine in this scenario will be presented.
The available observational literature on the topic of ketamine for agitation was recently summarized in a systematic review. This review found that ketamine effectively and quickly sedates acutely agitated patients. However, it did raise some concerns about an increased intubation rate in patients administered ketamine.
In severely agitated patients, particularly those presumed to be caused by stimulant drug use, who need immediate sedation to ensure the safety of the patient and staff, ketamine is a reasonable and safe choice. Emergency practitioners can consider giving ketamine 4-6 mg/kg IM (500 mg for most adults). Once given, it is important to closely monitor the patient for adverse effects and that the examination continue to determine the etiology of the patient’s agitation.
KeywordsKetamine Agitation Emergency services Pre-hospital
Compliance With Ethical Standards
Conflict of Interest
Rich Childers, MD, has no conflict of interest. Gary Vilke, MD, occasionally serves as a paid legal consultant.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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