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EMR
EMT
AEMT
Paramedic
Extended
Excited Delirium
Excited Delirium
Scene Safety
Law Enforcement should always
be requested
Universal Patient Assessment
Remove patient from stressful
environment
Only restrain the patient if
they are threatening the
safety of themselves, the
crew, or others. Do not
attempt to subdue or restrain
unless adequate personnel
are present and law
enforcement is on the scene.
Evacuate if they are not.
Try to identify and treat the
underlying cause of the agitation.
Ketamine
5mg/kg IM
Have suction, BVM, and intubation equipment
ready, be prepared to protect the airway, consider
extra resources. Monitor SpO2 and ETCO2.
Keep in mind that many accidental
needle sticks occur on medical
personnel while dealing with
violent or agitated patients.
Clinical Considerations
Agitation causes may include:
Excessive heat/cold
Hypoxia
Lack of blood flow to brain
Head injury or stroke
High or low BGL
Metabolic disorders
Neurologic disease
Excited Delirium
N-O-T A C-R-I-M-E
Naked (they strip)
Object (violence against)
Tough (they are strong)
Acute (onset)
Confused
Resistant (to commands)
Incoherent speech
Mental health issues -or-
Makes you uneasy
Early request of backup
If an IV/IO line is already established:
Ketamine
2mg/kg IV/IO
Paramedics who are not RSI
certified may elect to call in for
Online Medical Direction
to
give
Ketamine
5mg/kg IM for
Excited Delirium