Evidence map›Paper›PMID 30477544›Full record

ArticleTrials2018

Rapid agitation control with ketamine in the emergency department (RACKED): a randomized controlled trial protocol.

David Barbic, Gary Andolfatto, Brian Grunau, Frank X Scheuermeyer, William MacEwan, William G Honer, Hubert Wong, Skye P Barbic

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03375671 (Rapid Agitation Control With Ketamine in the Emergency Department), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03375671 phase2completednot on this map

Rapid Agitation Control With Ketamine in the Emergency Department (RACKED): a Randomized Controlled Trial

TypeinterventionalSponsorDavid BarbicRan2018 to 2020Enrolled81ConditionsViolent Aggressive Behavior, KetamineArmsKetalar, Midazolam injection, Haloperidol
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

David BarbicDepartment of Emergency Medicine, St Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada. David.barbic@ubc.ca.ORCID http://orcid.org/0000-0002-6998-3151
Gary AndolfattoDepartment of Emergency Medicine, Lion's Gate Hospital, 231 15th St E, North Vancouver, BC, Canada.
Brian GrunauDepartment of Emergency Medicine, St Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada.
Frank X ScheuermeyerDepartment of Emergency Medicine, St Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada.
William MacEwanDepartment of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
William G HonerDepartment of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Hubert WongSchool of Public Health and Epidemiology, University of British Columbia, Vancouver, BC, Canada.
Skye P BarbicDepartment of Occupational Science and Occupational Therapy, Vancouver, BC, Canada.
St. Paul's Hospital · CAUniversity of British Columbia · CALions Gate Hospital · CASpinal Cord Injury BC · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rapid control of patients presenting to the emergency department (ED) with psychomotor agitation and violent behavior is paramount for the safety of patients and ED staff. The use of intramuscular (IM) ketamine in the pre-hospital and ED settings has demonstrated promising preliminary results to provide rapid and safe behavioral control. A prospective, randomized controlled trial is required to measure the potential superiority of IM ketamine compared to current standard care (IM benzodiazepines plus antipsychotics).

methodsThis will be a parallel, prospective, randomized, controlled trial of 5 mg/kg IM ketamine compared to a combination of 5 mg IM midazolam and 5 mg IM haloperidol. The study will enroll approximately 184 patients, randomized equally to two study arms. There will be one study visit during which study medication will be administered and assessments will be completed. A follow-up safety visit will occur on day 3. The primary objective of this study is to compare IM ketamine to a combination of IM midazolam and haloperidol with regards to the time required for adequate behavioral control, in minutes, in patients presenting to the ED with psychomotor agitation and violent behavior, as measured by the Richmond Agitation-Sedation Scale (RASS). DISCUSSION: We present a novel study to determine whether ketamine is a rapid and safe option, compared to a combination of midazolam and haloperidol for the sedation of patients presenting to the ED with psychomotor agitation and violent behavior. To our knowledge, this study is the first randomized controlled trial to compare ketamine to current standard care for this indication. We have attempted to address numerous logistical issues with the design of this study including a waiver of consent, ensuring adequate blinding of outcome assessors, patient enrolment, and data monitoring.

trial registrationClinicaltrials.gov, NCT03375671 . Registered on 18 December 2017.

Indexed as

Emergency Service, HospitalAdultAnesthetics, DissociativeBritish ColumbiaFemaleHaloperidolHumansHypnotics and SedativesInjections, IntramuscularKetamineMaleMidazolamMiddle AgedProspective StudiesPsychomotor AgitationRandomized Controlled Trials as TopicAnesthetics, DissociativeHaloperidolHypnotics and SedativesKetamineMidazolamAgitationEmergency medicineHaloperidolKetamineMidazolamRandomized controlled trial

Identifiers

PMID30477544
PMCPMC6258312
OpenAlexW2902117384

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.