Colorado State EMS Conference 2020

References for my talk at The Virtual Colorado State EMS Conference 2020!
Please reach out if you have any questions or comments:
Twitter: @amerelman

Here is a link to my podcast with Reuben Strayer on agitation management:

My podcast on ketamine for pain:

Other Resources

Orhurhu VJ, Claus LE, Vashisht R, et al. Ketamine Toxicity. [Updated 2020 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.

Beaudoin FL, Lin C, Guan W, Merchant RC. Low-dose ketamine improves pain relief in patients receiving intravenous opioids for acute pain in the emergency department: results of a randomized, double-blind, clinical trial. Acad Emerg Med. 2014 Nov;21(11):1193-202. doi: 10.1111/acem.12510.  

Frey TM, Florin TA, Caruso M, Zhang N, Zhang Y, Mittiga MR. Effect of Intranasal Ketamine vs Fentanyl on Pain Reduction for Extremity Injuries in Children: The PRIME Randomized Clinical Trial. JAMA Pediatr. 2019 Feb 1;173(2):140-146. doi: 10.1001/jamapediatrics.2018.4582.

Ghate G, Clark E, Vaillancourt C. Systematic review of the use of low-dose ketamine for analgesia in the emergency department. CJEM. 2018 Jan;20(1):36-45. doi: 10.1017/cem.2017.48.

Jabourian, A., Dong, F., Lux, P., Vaezazizi, R., Mackey, K., Troy Pennington, T., & Neeki, NM. (2019). Safety And Efficacy of Prehospital Paramedic Administration of Ketamine In Adult Civilian Population. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 20(5.1).

Lumanauw DD, Youn S, Horeczko T, Yadav K, Tanen DA. Subdissociative-dose Ketamine Is Effective for Treating Acute Exacerbations of Chronic Pain. Acad Emerg Med. 2019 Sep;26(9):1044-1051. doi: 10.1111/acem.13755. Epub 2019 Apr 29.

Quinn K, Kriss S, Drapkin J, Likourezos A, Pushkar I, Brady J, Yasavolian M, Chitnis SS, Motov S, Fromm C. Analgesic Efficacy of Intranasal Ketamine Versus Intranasal Fentanyl for Moderate to Severe Pain in Children: A Prospective, Randomized, Double-Blind Study. Pediatr Emerg Care. 2018 Jul 24. doi: 10.1097/PEC.0000000000001556.

Rosenbaum SB, Palacios JL. Ketamine. [Updated 2019 Feb 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from:

Sleigh J, Harvey M, Voss L, Denny B. Ketamine – More mechanisms of action than just NMDA blockade. Trends in Anaesth. and Crit Care. 2014 June;4(2-3):76-81. doi:

Joly LM, Benhamou D. Ventilation during total intravenous anaesthesia with ketamine. Can J Anaesth. 1994 Mar;41(3):227-31. doi:

Melendez E, Bachur R. Serious adverse events during procedural sedation with ketamine. Pediatr Emerg Care. 2009 May;25(5):325-8.
doi: 10.1097/PEC.0b013e3181a341e0.

Strayer RJ, Nelson LS. Adverse events associated with ketamine for procedural sedation in adults. Am J Emerg Med. 2008 Nov;26(9):985-1028. doi: 10.1016/j.ajem.2007.12.005. Review. Erratum in: Am J Emerg Med. 2009
May;27(4):512. doi:10.1016/j.ajem.2007.12.005.

Mo H, Campbell MJ, Fertel BS, et al. Ketamine Safety and Use in the Emergency Department for Pain and Agitation/Delirium: A Health System Experience. West J Emerg Med. 2020;21(2):272-281. Published 2020 Jan 27. doi:10.5811/westjem.2019.10.43067

Lebin JA, Akhavan AR, Hippe DS, et al. Psychiatric Outcomes of Patients With Severe Agitation Following Administration of Prehospital Ketamine. Acad Emerg Med. 2019;26(8):889-896. doi:10.1111/acem.13725

Isenberg DL, Jacobs D. Prehospital Agitation and Sedation Trial (PhAST): A Randomized Control Trial of Intramuscular Haloperidol versus Intramuscular Midazolam for the Sedation of the Agitated or Violent Patient in the Prehospital Environment. Prehosp Disaster Med. 2015;30(5):491-495. doi:10.1017/S1049023X15004999

Sener S, Eken C, Schultz CH, Serinken M, Ozsarac M. Ketamine with and without midazolam for emergency department sedation in adults: a randomized controlled trial. Ann Emerg Med. 2011;57(2):109-114.e2. doi:10.1016/j.annemergmed.2010.09.010

Riddell J, Tran A, Bengiamin R, Hendey GW, Armenian P. Ketamine as a first-line treatment for severely agitated emergency department patients. Am J Emerg Med. 2017;35(7):1000-1004. doi:10.1016/j.ajem.2017.02.026

Sih K, Campbell SG, Tallon JM, Magee K, Zed PJ. Ketamine in adult emergency medicine: controversies and recent advances. Ann Pharmacother. 2011;45(12):1525-1534. doi:10.1345/aph.1Q370

Bailey AM, Baum RA, Horn K, et al. Review of Intranasally Administered Medications for Use in the Emergency Department. J Emerg Med. 2017;53(1):38-48. doi:10.1016/j.jemermed.2017.01.020

Mankowitz SL, Regenberg P, Kaldan J, Cole JB. Ketamine for Rapid Sedation of Agitated Patients in the Prehospital and Emergency Department Settings: A Systematic Review and Proportional Meta-Analysis. J Emerg Med. 2018;55(5):670-681. doi:10.1016/j.jemermed.2018.07.017

Linder LM, Ross CA, Weant KA. Ketamine for the Acute Management of Excited Delirium and Agitation in the Prehospital Setting. Pharmacotherapy. 2018;38(1):139-151. doi:10.1002/phar.2060

Heydari F, Gholamian A, Zamani M, Majidinejad S. Effect of Intramuscular Ketamine versus Haloperidol on Short-Term Control of Severe Agitated Patients in Emergency Department; A Randomized Clinical Trial. Bull Emerg Trauma. 2018;6(4):292-299. doi:10.29252/beat-060404

Cole JB, Klein LR, Nystrom PC, et al. A prospective study of ketamine as primary therapy for prehospital profound agitation. Am J Emerg Med. 2018;36(5):789-796. doi:10.1016/j.ajem.2017.10.022

Merelman AH, Perlmutter MC, Strayer RJ. Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine. West J Emerg Med. 2019;20(3):466-471. doi:10.5811/westjem.2019.4.42753

Umunna BP, Tekwani K, Barounis D, Kettaneh N, Kulstad E. Ketamine for continuous sedation of mechanically ventilated patients. J Emerg Trauma Shock. 2015;8(1):11-15. doi:10.4103/0974-2700.145414

Kurdi MS, Theerth KA, Deva RS. Ketamine: Current applications in anesthesia, pain, and critical care. Anesth Essays Res. 2014;8(3):283-290. doi:10.4103/0259-1162.143110