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Reicher D. 
“High-Dose Ketamine Sedation of an Agitated Patient During Air Medical Transport”. 
Air Med J. 2016 Mar-Apr 29;35(2):84-5.
Abstract
We report a case in which a high-dose ketamine infusion was used to sedate an agitated patient for air medical transport, avoiding the risks of general anesthesia and causing no exacerbation of psychiatric symptoms.

Highlights

The air medical transport of agitated patients presents significant risk to patients, medical staff, aircrew, and the aircraft itself. A recent consensus statement by Australian air medical retrieval services outlines strategies for safe sedation in this patient group. Ketamine infusion has been used to avoid the risks of general anesthesia and intubation of agitated patients in this setting.

In this case, a high-dose ketamine infusion was used to sedate a 16-year-old male with bipolar disorder who became agitated during preparation for fixed wing transport. The sedation was well tolerated and caused no exacerbation of his psychiatric symptoms.

This case contributes to the experiential evidence that even at high doses ketamine has been safely used to sedate agitated patients with known psychiatric illness.
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