Agitation w/ Reuben Strayer

The Paramedic Practitioner

On this episode I am lucky to have Dr. Reuben Strayer on to discuss the management of agitated patients. Dr. Strayer is an emergency physician in New York City and has interest and expertise in the management of agitation as well as sedation and airway management. Agitated patients are often challenging to treat. They require a high-level of assessment skill and a tailored treatment plan. There is a spectrum of agitation and it is important to determine where your patient falls to choose the correct management. This episode is a framework of the agitation spectrum and treatment options for the various types of patients we see.

Ketamine dose continuum (all doses IV unless indicated) With ketamine the two therapeutic ranges are analgesic and dissociation. We generally avoid the two middle ranges. For agitation, the only reliable use is to target dissociation using at least 3 mg/kg IM.

A Law Enforcement Approach to ExDS

References and Resources

Disruption, Danger, and Droperidol: Emergency Management of the Agitated Patient

EMCrit 279 – The Decision to use Ketamine – Disruptive and Dangerous with Reub Strayer

BCE 75 Reuben Strayer’s Agitated Patient

emDocs Cases: ED Approach to Agitation

https://www.nuemblog.com/blog/chemical-sedation
https://www.acepnow.com/article/droperidol-is-back-and-heres-what-you-need-to-know/

http://www.tamingthesru.com/blog/2019/4/20/the-return-of-droperidol

https://havokjournal.com/fitness/medical/ketamine-it-may-not-be-a-solution-for-everything-but-its-not-at-fault-here/

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