{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:45:51Z","timestamp":1784594751205,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the use of sublingual ketamine wafers administered by volunteer emergency medical technicians (EMTs) for pain management to patients in rural Western Australia (WA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study included patients older than 12\u2009years who were attended by volunteer EMTs in Esperance, Lancelin and Kalbarri, WA and received analgesic medications from 2018 to 2021. Patients who received ketamine wafers with\/without other analgesics were compared to (i) patients who received only oral paracetamol and (ii) patients who received inhalational methoxyflurane without ketamine wafers with\/without paracetamol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The present study included 826 patients, among whom 149 patients received ketamine wafer with\/without other analgesics, 82 paracetamol only and 595 methoxyflurane with\/without paracetamol. Patients who received ketamine wafers were younger (median age 49\u2009years <jats:italic>vs<\/jats:italic> 54\u2009years for the paracetamol group <jats:italic>vs<\/jats:italic> 58\u2009years for the methoxyflurane group), required a longer median transport interval (56\u2009min <jats:italic>vs<\/jats:italic> 20\u2009min <jats:italic>vs<\/jats:italic> 8\u2009min), trauma\u2010related (73% <jats:italic>vs<\/jats:italic> 35% <jats:italic>vs<\/jats:italic> 54%), and presented higher median initial pain score (9 <jats:italic>vs<\/jats:italic> 3 <jats:italic>vs<\/jats:italic> 8 out of 10) than those who received paracetamol and those who received methoxyflurane, respectively. Eight in the ketamine wafers group (5.4%) had a record of nausea\/vomiting after the administration of ketamine wafers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sublingual ketamine wafer was administered by volunteer EMTs without any evidence of major adverse events in rural WA and deemed useful as an additional pain management option when long transport to hospital was needed. No other symptoms that may be associated with the use of ketamine were recorded.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14226","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T23:55:15Z","timestamp":1682985315000},"page":"786-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of ketamine wafer for pain management by volunteer emergency medical technicians in rural Western Australia"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-8004","authenticated-orcid":false,"given":"Hideo","family":"Tohira","sequence":"first","affiliation":[{"name":"Prehospital, Resuscitation and Emergency Care Research Unit, Curtin School of Nursing Curtin University  Perth Western Australia Australia"},{"name":"Discipline of Emergency Medicine, Medical School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deon","family":"Brink","sequence":"additional","affiliation":[{"name":"Prehospital, Resuscitation and Emergency Care Research Unit, Curtin School of Nursing Curtin University  Perth Western Australia Australia"},{"name":"St John Ambulance Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Davids","sequence":"additional","affiliation":[{"name":"St John Ambulance Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolph","family":"Brits","sequence":"additional","affiliation":[{"name":"St John Ambulance Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9457-3381","authenticated-orcid":false,"given":"Stephen","family":"Ball","sequence":"additional","affiliation":[{"name":"Prehospital, Resuscitation and Emergency Care Research Unit, Curtin School of Nursing Curtin University  Perth Western Australia Australia"},{"name":"St John Ambulance Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0302-2315","authenticated-orcid":false,"given":"Stephan","family":"Schug","sequence":"additional","affiliation":[{"name":"Discipline of Anaesthesiology and Pain Medicine, Medical School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Bailey","sequence":"additional","affiliation":[{"name":"St John Ambulance Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7307-7944","authenticated-orcid":false,"given":"Judith","family":"Finn","sequence":"additional","affiliation":[{"name":"Prehospital, Resuscitation and Emergency Care Research Unit, Curtin School of Nursing Curtin University  Perth Western Australia Australia"},{"name":"St John Ambulance Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2010.098954"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X12000180"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2010.541980"},{"key":"e_1_2_8_5_1","unstructured":"St John Ambulance Western Australia.Relief of Pain Clinical Practice Guidelines Belmont Western Australia. 2022. 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