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Ketamine sedation for patients with acute agitation and psychiatric illness requiring aeromedical retrieval
  1. Minh Le Cong1,
  2. Bruce Gynther2,
  3. Ernest Hunter2,
  4. Peter Schuller3
  1. 1Royal Flying Doctor Service, Cairns Base, Aeroglen, Queensland, Australia
  2. 2Remote Area Mental Health Service, Cairns District, Queensland, Australia
  3. 3Department of Anaesthesia, Cairns Base Hospital, Peri-Operative and Critical Care Medicine, Queensland, Australia
  1. Correspondence to Dr Minh Le Cong, Royal Flying Doctor Service, Cairns Base, Aeroglen 4870, Queensland, Australia; mlecong{at}


Objective Aeromedical retrieval services face the difficult problem of appropriate levels of sedation for transport of acutely agitated patients to definitive care. This paper describes a technique using ketamine, which is titratable and avoids problems associated with airway management.

Method A 3-year review of a new technique of ketamine sedation by aeromedical retrieval teams from the Cairns base of the Queensland section of the Royal Flying Doctor Service of Australia. Clinical records were systematically reviewed for ketamine administration and signs of adverse events during transport and in the subsequent 72 h.

Results 18 patients were sedated during retrieval with intravenous ketamine. Effective sedation was achieved in all cases, with no significant adverse events noted during retrieval or 72 h afterwards.

Conclusion Ketamine sedation is effective and safe in agitated patients with a psychiatric illness in the aeromedical setting and does not lead to worsening agitation in the subsequent 72-h period.

  • Aeromedical
  • anaesthesia
  • critical care transport
  • emergency care systems
  • ketamine
  • prehospital care
  • psychiatric
  • psychological conditions
  • psychology
  • remote and rural medicine
  • retrieval
  • sedation

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Queensland Health Human Research Ethics Committee (Cairns).

  • Provenance and peer review Not commissioned; externally peer reviewed.