Methodology: 2.5/5
Usefulness: 3/5

Lin J, et al. Am J Emerg Med. 2021 Jun;44:306-311.

Question and Methods: Open-label prospective study comparing the efficacy and safety of ketamine versus haloperidol plus lorazepam in the treatment of acute combative agitation in the ED.

Findings: Significantly more patients treated with ketamine compared to haloperidol/lorazepam were sedated within 5 minutes (22% vs. 0%, p = 0.001).

Limitations: Potential bias secondary to open-label design, no allocation concealment, unblinded design, small sample size, and limited patient screening/enrollment based on physician practice patterns.

Interpretation: Ketamine remains a viable option for the rapid treatment of acute combative agitation in the ED, with haloperidol and lorazepam providing slower but equally adequate sedation.

By: Dr. Maeghan Fu

 

Authors

  • Dr. Maeghan Fu is an FRCPC Emergency Medicine resident in the Department of Emergency at the University of Ottawa.

  • Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.