Is ketamine safe and effective in excited delirium?

Zerbor/shutterstock.com 3 out of 5 stars Ketamine as Rescue Treatment for Difficult-to-Sedate Severe Acute Behavioral Disturbance in the Emergency Department. Isbister GK et al. Ann Emerg Med 2016 Feb 10 [Epub ahead of print] Abstract Rapidly sedating a toxicology patient who presents with excited delirium is a critical — yet often difficult — action. These patients are typically difficult to control and resistant to sedation with commonly used agents such as benzodiazepines and antipsychotics. They also have high mortality rates. The key to obtaining good outcomes in these cases is prompt evaluation and support, focusing on the ABCs and hydration, as well as early detection and treatment of hypoglycemia and hyperthermia. The aim of this prospective observational study was to evaluate the safety and efficacy of ketamine as rescue therapy for sedating excited delirium patients who had not responded to standard agents. As part of a therapeutic protocol, adult (> 16 years old) patients with excited delirium were given up to 2 doses of 10-mg IM droperidol 15 minutes apart. If sedation was not achieved, IM ketamine (4 – 6 mg/kg) was recommended after consult with the toxicology service. Of nearly 1300 excited delirium patients who received droperidol, 49 were not adequately sedated after 2 doses. Five of the 49 were not sufficiently sedated within 120 minutes of receiving ketamine and/or required additional sedation. Many of those 5 patients seem to have received IM k...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical excited delirium ketamine sedation Source Type: news