Intravenous ketamine to facilitate transport of agitated patients to the ECT clinic

Dean, Olivia, Byford-Brooks, Anthony, Hannigan, Kara, Saunders, Danielle, Gamble, William and Kirov, George ORCID: https://orcid.org/0000-0002-3427-3950 2024. Intravenous ketamine to facilitate transport of agitated patients to the ECT clinic. The Journal of ECT 10.1097/YCT.0000000000001090

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Abstract

Objectives: Electroconvulsive therapy (ECT) can be effective for a variety of psychiatric conditions, including for some patients who are very psychotic or agitated. Transferring such patients from the psychiatric ward to the ECT clinic can pose significant challenges for treating teams, as they try to minimize the use of restraint. Methods: We developed a protocol for safe transfer of such patients using sedation with ketamine. An intravenous cannula is inserted on the ward in a low stimulus environment with gentle supportive holds. Intravenous ketamine is given in a bolus at 0.5–2.0 mg/kg. The patient is transported on a transfer bed to the ECT clinic within a few minutes, and usual ECT process is immediately followed. Results: We describe 6 patients who were given between 1 and 11 ECT treatments using this method. All of them finished ECT courses without the need for ketamine sedation. Five of them regained capacity, provided informed consent for further ECTs, and eventually reached remission. Conclusions: Ketamine can be used to manage risk and transfer agitated patients to an ECT clinic for treatment.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Medicine
Publisher:	Lippincott, Williams & Wilkins
ISSN:	1533-4112
Date of First Compliant Deposit:	18 December 2024
Date of Acceptance:	16 October 2024
Last Modified:	19 Dec 2024 11:00
URI:	https://orca.cardiff.ac.uk/id/eprint/174800

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