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This study looks at the efficacy of ketamine vs. midazolam for the prehospital sedation of acutely agitated patients, examining the need for repeat sedation (by EMS or in the ED), adverse events and length of stay.
A greater number of patients required repeat sedation within 90 minutes with initial ketamine dosing compared to midazolam. There was no difference in patients receiving repeat sedation within 20 minutes between the two groups.
There were no significant differences in time to repeat sedation, total sedation doses (by EMS or in the ED), use of bag valve mask ventilation or intubation, use of physical restraints, admission location/level of care, or length of stay in the Emergency Department (ED), hospital, or Intensive Care Unit.
References
Holland D, Glober N, Christopher S, Zahn E, Lardaro T, O'Donnell D. Prehospital sedation with ketamine vs. midazolam: Repeat sedation, intubation, and hospital outcomes. Am J Emerg Med. 2020;38(9):1748-1753. doi:10.1016/j.ajem.2020.05.011