Ketamine Sedation for Patients With Acute Behavioral Disturbance During Aeromedical Retrieval: A Retrospective Chart...

Area of Science:

• Emergency Medicine
• Pharmacology
• Critical Care

Background:

• Acute behavioral disturbance (ABD) poses challenges during emergency medical retrieval.
• Sedation is often necessary but requires careful consideration of safety and efficacy.
• Air medical retrieval presents unique environmental factors influencing patient management.

Purpose of the Study:

• To evaluate the safety and effectiveness of ketamine for sedating patients with ABD during air medical retrieval.
• To determine the incidence of adverse events and intubations associated with ketamine use in this population.
• To assess the prevalence of ketamine sedation in air medical retrievals for ABD.

Main Methods:

• Retrospective observational study of adult patients with ABD undergoing air medical retrieval in Queensland, Australia.
• Data collected from electronic databases between January 1, 2015, and June 30, 2016.
• Primary outcomes included intubation rates and adverse reactions to ketamine.

Main Results:

• 122 patients met inclusion criteria; 25.4% were intubated (17.2% for airway protection/respiratory depression, 8.1% for persistent ABD).
• 17.2% of patients received ketamine; 14.3% of those were intubated for persistent ABD.
• Adverse events included hypertension (14.3%), hypoxia (4.8%), and increased secretions (4.8%); no nausea, vomiting, or apnea occurred.

Conclusions:

• Ketamine appears to be a safe and effective agent for sedating patients with acute behavioral disturbance during air medical retrieval.
• The observed adverse event profile suggests ketamine can be used judiciously in this high-acuity setting.
• Further research could explore optimal ketamine dosing and monitoring protocols in air medical services.