It’s time for another post on everyone’s favourite drug: ketamine! Hooray! Ok, so this is not entirely about ketamine, but ketamine does come into it. AV paramedics have recently received training to administer IM ketamine to agitated patients as part of a greater focus on paramedic safety when managing these situations(MICA paramedics have had ketamine for […]
via Just Kalm Down! — AmboFOAM
Editors note : I find it surprising given the Australian research published on acute behavioural disturbance and updated guidelines in Queensland and NSW recently, that droperidol is not included in these latest Victorian Ambulance protocols. Why it has not replaced midazolam given its superior safety profile in the research, is baffling. And when its written that mild – moderate agitation can be managed with “a little midazolam”, I would suggest an oral agent is likely just as effective in this situation than a needle.
Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds 
Re The Editors Note. In practice the mild/moderate agitation means it only takes 2 or 3 police to restrain them rather than 4, 5 or 6 for the extremely agitated. So the oral route is not really a viable option. If I could convince them to take a tablet then I probably don’t really need to sedate them. Of course suppositoties may be an option.
Having to need physical restraint does not mean it’s mild to moderate agitation in my view . If you need to use a needle it should be severe agitation and a last resort . You would be surprised how many will take oral medication if asked . Isn’t it worth at least carrying oral sedatives as an option?