{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T07:19:50Z","timestamp":1772263190974,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:00:00Z","timestamp":1605571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Senior Research Fellowship ID1061041"],"award-info":[{"award-number":["Senior Research Fellowship ID1061041"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Rapidly and safely managing severe acute behavioural disturbance (ABD) in the prehospital setting is important for the welfare of both patient and prehospital clinician alike. We investigated the safety and effectiveness of ketamine as rescue sedation in patients with severe ABD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study investigated ketamine use by a state ambulance service as rescue sedation for patients with severe ABD who remained agitated following droperidol administration. The primary outcome was the proportion of adverse events (vomiting, hypersalivation, emergence, over\u2010sedation, airway obstruction, laryngospasm, hypoxia, bradypnoea and intubation). Secondary outcomes included time to sedation, requirement for additional sedation and rate of successful sedation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 105 presentations (males 69\/102 [69%]; median age 31\u2009years (16\u201383\u2009years). The commonest causes of ABD were illicit drug (39%) and alcohol (33%) intoxication. The median total dose of intramuscular ketamine was 200\u2009mg (interquartile range [IQR] 150\u2013200\u2009mg). There were 64 adverse events in 40 (38%) patients. Four had vomiting, two had hypersalivation, two had emergence, 15 were oversedated, four had hypoxia, three had bradypnoea and 16 were intubated. Sedation was achieved in 103 (98%) patients at a median time post\u2010ketamine of 8\u00a0min (IQR 5\u201313\u2009min). Additional sedation was administered to 41 patients (nine prehospital and 37 within 1\u2009h of arriving to hospital). In 44 (42%) patients, ketamine successfully sedated the patient with no adverse effects and no ongoing sedation requirement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of ketamine as rescue sedation in prehospital patients with severe ABD is effective. Adverse events are common but can be managed supportively.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13682","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T05:26:17Z","timestamp":1605677177000},"page":"610-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["K<scp>etamine as<\/scp> a <scp>rescue treatment for severe acute behavioural disturbance<\/scp>: A prospective prehospital study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-7923","authenticated-orcid":false,"given":"Katherine Z","family":"Isoardi","sequence":"first","affiliation":[{"name":"Department of Clinical Toxicology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Clinical Toxicology Research Group The University of Newcastle  Newcastle New South Wales Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lachlan E","family":"Parker","sequence":"additional","affiliation":[{"name":"Queensland Ambulance Service  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin B","family":"Page","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Clinical Toxicology Research Group The University of Newcastle  Newcastle New South Wales Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland 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