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Ketamine for agitated patients in ER more effective than traditional methods

Treatment of highly agitated or violent patients in the emergency department with ketamine is more effective than traditional approaches, and could be safer for patients and staff. These results are from an innovative clinical trial led by CHÉOS Scientist Dr. David Barbic and published this week in Annals of Emergency Medicine.

The study compared the effectiveness of ketamine, a sedative, to midazolam and haloperidol, a benzodiazepine and antipsychotic combination commonly used in emergency departments in these circumstances.

Midazolam and haloperidol are effective, but can increase the risk of respiratory and neurological issues.


Dr. David Barbic

“We see patients presenting to the emergency department agitated, aggressive, and with potentially violent behaviour every day,” said Dr. Barbic. “Previous research suggested that ketamine could be quicker and safer but we needed a randomized trial to be sure.”

With support from CHÉOS Project Manager Leslie Love and Statistician Hong Qian, Dr. Barbic and his team, which includes CHÉOS Scientists Drs. Brian GrunauFrank ScheuermeyerHubert Wong, and Skye Barbic, launched the Rapid Agitation Control with Ketamine in the Emergency Department Study in the spring of 2018.

Over the next two years, the study enrolled 80 patients at the St. Paul’s Hospital Emergency Department who were severely agitated. Patients were randomized to receive either ketamine or the standard treatment of midazolam and haloperidol, both via injection. Patients were then monitored and underwent standardized testing, including blood screening and ECG.

The researchers were primarily looking at how long it took for patients to become adequately sedated in order to receive appropriate care, but they also looked at adverse events and the need for additional sedative medications.

View the full article here on CHÉOS News | Ketamine for agitated patients in ER more effective than traditional methods