Emergency Medical Services, Regions Hospital, Saint Paul, Minnesota 55101, USA.
Prehosp Emerg Care. 2012 Jul-Sep;16(3):412-4. doi: 10.3109/10903127.2011.640766. Epub 2012 Jan 17.
An advanced life support emergency medical services (EMS) unit was dispatched with law enforcement to a report of a male patient with a possible overdose and psychiatric emergency. Police restrained the patient and cleared EMS into the scene. The patient was identified as having excited delirium, and ketamine was administered intramuscularly. Sedation was achieved and the patient was transported to the closest hospital. While in the emergency department, the patient developed laryngospasm and hypoxia. The airway obstruction was overcome with bag-valve-mask ventilation. Several minutes later, a second episode of laryngospasm occurred, which again responded to positive-pressure ventilation. At this point the airway was secured with an endotracheal tube. The patient was uneventfully extubated several hours later. This is the first report of laryngospam and hypoxia associated with prehospital administration of intramuscular ketamine to a patient with excited delirium.
一个高级生命支持的紧急医疗服务（EMS）单位被派往一个报告的可能过量和精神病紧急情况的男性患者。警方限制了患者，并允许 EMS 进入现场。患者被确认为兴奋谵妄，并给予肌肉注射氯胺酮。镇静后，患者被送往最近的医院。在急诊室，患者出现喉痉挛和缺氧。气道阻塞通过球囊面罩通气得到缓解。几分钟后，第二次喉痉挛发生，再次对正压通气有反应。此时，通过气管内插管固定气道。数小时后，患者顺利拔管。这是首例报道的与院前给予肌肉注射氯胺酮治疗兴奋谵妄患者相关的喉痉挛和缺氧病例。
