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{
    "pk": 14738,
    "title": "Outcomes Associated with Lower Doses of Ketamine by Emergency Medical Services for Profound Agitation",
    "subtitle": null,
    "abstract": "Introduction:\n Ketamine is commonly used to treat profound agitation in the prehospital setting. Early in ketamine’s prehospital use, intubation after arrival in the emergency department (ED) was frequent. We sought to measure the frequency of ED intubation at a Midwest academic medical center after prehospital ketamine use for profound agitation, hypothesizing that intubation has become less frequent as prehospital ketamine has become more common and prehospital dosing has improved.\nMethods:\n We conducted a retrospective cohort study of adult patients receiving ketamine in the prehospital setting for profound agitation and transported to a midwestern, 60,000-visit, Level 1 trauma center between January 1, 2017–- March 1, 2021. We report descriptive analyses of patient-level prehospital clinical data and ED outcomes. The primary outcome was proportion of patients intubated in the ED. \nResults:\n A total of 78 patients received ketamine in the prehospital setting (69% male, mean age 36 years). Of the 42 (54%) admitted patients, 15 (36% of admissions) were admissions to the intensive care unit. Overall, 12% (95% confidence interval [CI]), 4.5-18.6%)] of patients were intubated, and indications included agitation (n = 4), airway protection not otherwise specified (n = 4), and respiratory failure (n = 1). \nConclusion:\n Endotracheal intubation in the ED after prehospital ketamine use for profound agitation in our study sample was found to be less than previously reported.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "ketamine, excited delirium, intubation, pre-hospital, EMS"
        }
    ],
    "section": "Emergency Medical Services",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8586430f",
    "frozenauthors": [
        {
            "first_name": "Shaila",
            "middle_name": "K.",
            "last_name": "Coffey",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa",
            "department": "None"
        },
        {
            "first_name": "J.",
            "middle_name": "Priyanka",
            "last_name": "Vakkalanka",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Carver College of Public Health, Department of Epidemiology, Iowa City, Iowa",
            "department": "None"
        },
        {
            "first_name": "Haley",
            "middle_name": "",
            "last_name": "Egan",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa",
            "department": "None"
        },
        {
            "first_name": "Kelli",
            "middle_name": "",
            "last_name": "Wallace",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa",
            "department": "None"
        },
        {
            "first_name": "Karisa",
            "middle_name": "K.",
            "last_name": "Harland",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Carver College of Public Health, Department of Epidemiology, Iowa City, Iowa",
            "department": "None"
        },
        {
            "first_name": "Nicholas",
            "middle_name": "M.",
            "last_name": "Mohr",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Carver College of Public Health, Department of Epidemiology, Iowa City, Iowa; University of Iowa Carver College of Medicine, Department of Anesthesia, Iowa City, Iowa",
            "department": "None"
        },
        {
            "first_name": "Azeemuddin",
            "middle_name": "",
            "last_name": "Ahmed",
            "name_suffix": "",
            "institution": "University of Iowa Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa; University of Iowa Tippie College of Business, Iowa City, Iowa",
            "department": "None"
        }
    ],
    "date_submitted": "2020-11-10T22:46:32Z",
    "date_accepted": "2020-11-10T22:46:32Z",
    "date_published": "2021-08-30T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14738/galley/7503/download/"
        }
    ]
}