Illustrative CasesA Novel Agent for Management of Agitated Delirium A Case Series of Ketamine Utilization in the Pediatric Emergency DepartmentKowalski, J. Michael DO*; Kopec, Kathryn T. DO†; Lavelle, Jane MD‡; Osterhoudt, Kevin MD‡§Author Information From the *Division of Medical Toxicology, Einstein Medical Center Philadelphia, Philadelphia, PA; †Duke University Medical Center, Durham, NC; and ‡Division of Emergency Medicine and §The Poison Control Center, The Children's Hospital of Philadelphia, Philadelphia, PA. Disclosure: The authors declare no conflict of interest. Reprints: John Michael Kowalski, DO, Division of Medical Toxicology, Einstein Medical Center, 5501 Old York Rd, Philadelphia, PA 19141 (e-mail: KowalskJ@einstein.edu). Pediatric Emergency Care: September 2017 - Volume 33 - Issue 9 - p e58-e62 doi: 10.1097/PEC.0000000000000578 Buy Metrics Abstract Control of the agitated patient in the emergency department is challenging. Many options exist for chemical sedation, but most have suboptimal pharmacodynamic action, and many have undesirable adverse effects. There are reports of ketamine administration for control of agitation prehospital and in traumatically injured patients. Ketamine is a noncompetitive N-methyl-D-aspartic acid receptor antagonist, making it an effective dissociative agent. We present 5 cases of ketamine administration to manage agitated adolescent patients with underlying psychiatric disease and/or drug intoxication. Ketamine, as a dissociative agent, may be an alternative pharmacological consideration for the control of agitation in patients with undifferentiated agitated delirium. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.