the agitated patient: protecting yourself and the patient
DESCRIPTION
Minh Le Cong, speaks about agitation in the ICU. His punchy talk covers why agitation happens (on both sides) as well as strategies for managing the agitated patient. The use and possibilities of ketamine for agitation and refractory depression is also discussed. This great podcast was recorded from the Bedside Critical Care Conference 2013.TRANSCRIPT
Agitation in ICUBy Dr Minh Le Cong
Royal Flying Doctor Service, Queensland
Prevention?
Haloperidol prophylaxis
Kalisvaart, JAGS 2005;53:1658-1666
Haloperidol and mortality
DEXMEDETOMIDINE VS. HALOPERIDOL IN DELIRIOUS, AGITATED, INTUBATED PATIENTS: A RANDOMISED OPEN-LABEL TRIALMICHAEL C READE*, KIM O'SULLIVAN, SAMANTHA BATES, DONNA GOLDSMITH, WILLIAM RSTJ AINSLIE AND RINALDO BELLOMOCRIT CARE 2009
Less delirium, more bradycardia
Check out www.emcrit.org
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What would you prepare and how would you give it?
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Use a sedation score
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ON ketamine 80mg/hr
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Ketamine for agitation ?? Are you nuts?
Growing research into ketamine in mental health
Rapid antidepressant Rapid Anti suicidal effect Can ameliorate/resolve PTSD
References http://images.fineartamerica.com/images-medium/mental-agitation-paulo-zerbato.jp
g http://www.google.com.au/imgres?imgurl=http://wpmedia.blogs.theprovince.com/20
12/09/icu2.jpg&imgrefurl=http://blogs.theprovince.com/2012/09/25/letters-end-of-life-icu-christy-clark-b-c-conservatives-food-labels-mp-costs-bike-lanes-police/&h=377&w=640&sz=90&tbnid=szFE3EPfjrA7gM:&tbnh=92&tbnw=156&zoom=1&usg=__jEPztWVntCwKHKlLG-enXTcZLr4=&docid=fRKRotkyBM4wTM&sa=X&ei=wcYeUoSpCquaiQeiyYDoBQ&ved=0CGkQ9QEwEg&dur=204
http://www.slideshare.net/hospira2010/patients-gone-wild-agitation-and-delirium-in-the-icu
http://www.goodrx.com/haloperidol/images#imgModal http://emcrit.org/podcasts/human-bondage-chemical-takedown/ http://media.photobucket.com/user/death_to_amerika/media/fight_club.jpg.html?
filters[term]=fight%20club&filters[primary]=images&filters[secondary]=videos&sort=1&o=8
http://www.mmafighting.com/2013/8/28/4669374/ufc-fight-night-27-photos http://i2.listal.com/image/1164347/600full-the-strangler-of-blackmoor-castle-
poster.jpg http://www.matilda.aktivix.org/collectives/ketamine/myths/1-horse-tranquilliser/
horse-tranquilliser.jpg http://www.webmd.com/drugs/drug-1596-droperidol+Inj.aspx?
drugid=1596&drugname=droperidol+Inj&pagenumber=2 http://www.forbes.com/sites/matthewherper/2013/05/23/johnson-johnson-is-
reinventing-the-party-drug-ketamine-to-treat-depression/