Evaluation of the Use of Ketamine in Prehospital Seizure Management: A Retrospective Review of the ESO Database.
Prehospital emergency care July 31, 2024 Joseph Daniel Finney, Paul D Schuler, James R Rudloff et al. 4 citations
Benzodiazepines fail to stop seizures in 30% to 40% of cases, a condition called benzodiazepine-refractory status epilepticus (BRSE). Ketamine is a potential treatment, but its use by emergency medical services (EMS) is poorly documented. A retrospective review of 99,576 EMS encounters for seizures from 2018 to 2021 found that ketamine was administered in 2.54% of cases. In 1,283 encounters without an airway procedure, 48% received ketamine alone and 52% received it with another antiseizure medication, most often midazolam. Ketamine use without an airway procedure rose from 0.90% to 1.45% over the study period, a 62% increase. Most administrations occurred in adult patients in the southern United States and urban areas. The growth in ketamine use supports prospective research into its value for prehospital seizure management.