title: A Novel Agent for Management of Agitated Delirium: A Case Series of Ketamine Utilization in the Pediatric Emergency Department.
abstract: Control of the agitated patient in the emergency department is challenging. Many options exist for chemical sedation, but most have suboptimal pharmacodynamic action, and many have undesirable adverse effects. There are reports of ketamine administration for control of agitation prehospital and in traumatically injured patients. Ketamine is a noncompetitive N-methyl-D-aspartic acid receptor antagonist, making it an effective dissociative agent. We present 5 cases of ketamine administration to manage agitated adolescent patients with underlying psychiatric disease and/or drug intoxication. Ketamine, as a dissociative agent, may be an alternative pharmacological consideration for the control of agitation in patients with undifferentiated agitated delirium.
authors.affiliation: From the *Division of Medical Toxicology, Einstein Medical Center Philadelphia, Philadelphia, PA; †Duke University Medical Center, Durham, NC; and ‡Division of Emergency Medicine and §The Poison Control Center, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Kowalski
authors.forename: Kathryn T
authors.initials: KT
authors.lastname: Kopec
authors.forename: Jane
authors.initials: J
authors.lastname: Lavelle
authors.forename: Kevin
authors.initials: K
authors.lastname: Osterhoudt
mesh_terms: D000293:Adolescent; D000778:Anesthetics, Dissociative / Q000627:therapeutic use; D003693:Delirium / Q000188:drug therapy*; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011595:Psychomotor Agitation / Q000188:drug therapy*
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine