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J Nerv Ment Dis. 2019 Jan;207(1):43-44. doi: 10.1097/NMD.0000000000000910.

Psychiatric Considerations Regarding Prehospital Administration of Ketamine for Agitation.

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Saint Louis University School of Medicine, and.
Department of Psychiatry, Saint Louis University School of Medicine, Saint Louis, MO.


Recently, ketamine has seen increased use among emergency medical services in the prehospital setting as a first-line means of chemical restraint for agitated patients. In this case report, we explore an instance in which ketamine administration for nonpsychotic agitation before emergency department (ED) evaluation may have caused unexpected psychotic symptoms leading to a complicated ED course necessitating admission. As ketamine gains widespread use in the prehospital setting, the safety profile deserves reevaluation. In the following report, we review relevant literature and discuss important factors to consider regarding the use of prehospital ketamine, including psychiatric and substance abuse history.

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