ArticleJournal of the American Geriatrics Society2026
Exploring Current Emergency Medical Services Approaches to Manage Agitated Older Adult Patients: An Analysis of Statewide Protocols.
Article in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Research and Knowledge Translation Priorities for the Prehospital Care of Older Adults: A Modified Delphi Study.Prehospital emergency care · 2026Article
- Research progress in agitation early warning monitoring and new technologies for critically ill patients: a narrative review.Frontiers in medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundAgitation in older adults presents unique challenges for emergency medical services (EMS) clinicians. To safely assess, treat, and transport these patients, EMS providers must manage this agitation, which is often caused by delirium or behavioral symptoms of dementia. Strategies routinely used in younger patients, such as physical restraints and chemical sedatives, have a much higher risk of causing harm in older adults. EMS provider practices in this area are understudied. Our objective was to examine U.S. state protocols for guidance on agitation management in older adults.
methodsWe reviewed publicly available statewide EMS protocols and the National EMS Model Guidelines to identify agitation management guidance and whether modifications for older adults were included. We assessed each protocol for the presence of 26 elements using a standardized approach.
resultsWe analyzed 34 state protocols and the National Model Guidelines. While 33 protocols (97%) included guidance for managing agitation and 19 protocols (58%) included pediatric-specific considerations, only 11 (33%) addressed older adults. Among these, the most common modification was sedative medication dose reduction (9 protocols, 27%). No protocols included modifications to guidance/criteria for physical restraint use, prioritization/escalation between physical restraint and chemical sedation, or sedative medication selection for older adults. Guidance on medication selection varied: 29 protocols (88%) included standing orders for sedative medications, most commonly midazolam (27 protocols, 82%), ketamine (23 protocols, 70%), haloperidol (17 protocols, 52%). Only 7 protocols (21%) included specific dose adjustments for older adults, typically a 50% reduction. Benzodiazepines were most commonly recommended, while antipsychotics were less common.
conclusionsMost state EMS protocols provide guidance on management of agitated patients, including use of physical restraints and chemical sedatives, yet modifications or specific guidance for older adults are uncommon. Recognizing and addressing this gap represents an important opportunity to improve quality of prehospital care for older adults.
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