Gangathimmaiah Vinay, Le Cong Minh, Wilson Mike, Hooper Kate, Perry Andrew, Burman Luke, Puckeridge Nathan, Maguire Brian J
LifeFlight Retrieval Medicine, Queensland, Australia.
Royal Flying Doctor Service, Queensland, Australia.
Air Med J. 2017 Nov-Dec;36(6):311-314. doi: 10.1016/j.amj.2017.06.004. Epub 2017 Aug 12.
The aim of this study was to determine the prevalence, safety (as measured by the incidence of adverse events), and effectiveness (as measured by the incidence of intubations) of ketamine sedation in patients with acute behavioral disturbance (ABD) during air medical retrieval.
This was a retrospective observational study. Eligible patients were identified by searching the electronic databases of 2 air medical retrieval services in Queensland, Australia, for adult patients with ABD transported between January 1, 2015, and June 30, 2016. Data abstraction was performed as per standard chart review criteria. The incidences of intubations and adverse reactions were the main outcomes.
One hundred twenty-two patients met the inclusion criteria. Thirty-one (25.4%) patients were intubated, 21 (17.2%) for airway protection/respiratory depression and 10 (8.1%) for persistent ABD. Twenty-one (17.2%) patients received ketamine, 3 of whom (14.3%) were intubated for persistent ABD. Nine (42.9%) patients developed hypertension after ketamine, 2 of whom needed intervention. One patient developed hypoxia after ketamine that resolved without intervention, and 1 patient developed increased secretions. No patients developed nausea, vomiting, emergence phenomena, apnea, or laryngospasm.
Our study suggests that ketamine is a safe and effective agent for sedating patients with ABD during air medical retrieval.
本研究旨在确定在航空医疗转运期间，氯胺酮用于急性行为障碍（ABD）患者镇静的患病率、安全性（通过不良事件发生率衡量）和有效性（通过插管发生率衡量）。
这是一项回顾性观察研究。通过检索澳大利亚昆士兰州两家航空医疗转运服务机构的电子数据库，确定符合条件的成年ABD患者，这些患者在2015年1月1日至2016年6月30日期间接受转运。按照标准图表审查标准进行数据提取。插管和不良反应的发生率是主要结局指标。
122例患者符合纳入标准。31例（25.4%）患者接受了插管，其中21例（17.2%）是为了气道保护/呼吸抑制，10例（8.1%）是为了持续性ABD。21例（17.2%）患者接受了氯胺酮治疗，其中3例（14.3%）因持续性ABD接受了插管。9例（42.9%）患者在使用氯胺酮后出现高血压，其中2例需要干预。1例患者在使用氯胺酮后出现低氧血症，未经干预自行缓解，1例患者出现分泌物增多。没有患者出现恶心、呕吐、苏醒期现象、呼吸暂停或喉痉挛。
我们的研究表明，在航空医疗转运期间，氯胺酮是一种用于镇静ABD患者的安全有效的药物。
