Although ketamine seemed effective in this small study, safety data for this use are insufficient to consider it a first-line treatment.
Researchers assessed the safety and effectiveness of ketamine for rescue sedation in a substudy of severely agitated and violent patients. In the parent study, roughly 1300 patients at two emergency departments (EDs) were managed with a standardized sedation protocol recommending 10-mg intramuscular droperidol as first-line treatment. After initial attempts at sedation failed, 49 of these patients (median age, 37; 57% men were given 4–6-mg/kg IM ketamine (median dose, 300 mg; range, 50–500 mg).
Median time to sedation after ketamine administration was 20 minutes (range, 2−500 minutes). Five patients did not achieve sedation within 2 hours, required more sedation within 1 hour, or both. Of these five patients, four had received ≤200-mg ketami…