Just a quick note of appreciation for Dr. James Roberts' recent series on rapid tranquilization of violently agitated patients.
I would like to compliment him on the review of the use of ketamine. Several of us have started using this for patients who seem to require six cops to restrain. It is paradigm-shifting. First, I get everyone off the patient and get the drug ready. Then I use them just enough to restrain the patient so I can give him IM ketamine through the pants into the thigh. Then I get everyone off him. He's down in two minutes, and we're off to the medical races.
What I don't understand is why the police don't use this approach. I understand the connotations of using an “animal” tranquilizer dart, but it would be much safer to use a ketamine dart on these violently agitated patients out on the street rather than violent physical confrontation where the person is at risk of sudden cardiac death. I think that TASERs should be replaced by ketamine. I just don't know how to get them to do it.
Thanks again to Dr. Roberts for his special insights and talents.
Mark L. DeBard, MD