Fast doesn't equal safe: rethinking sedation, risk, and responsibility in the field

Michael A Austin^{1

2

3

4}, Justin Godbout⁵, Andy Pan^{6

7

8

9

10}

Affiliations

¹ Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada. maustin@toh.ca.
² Ottawa Hospital Research Institute, Ottawa, ON, Canada. maustin@toh.ca.
³ Regional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada. maustin@toh.ca.
⁴ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. maustin@toh.ca.
⁵ Department of Emergency Medicine, Queensway Carleton Hospital, Ottawa, ON, Canada.
⁶ Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
⁷ Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁸ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁹ ORNGE Transport Medicine, Mississauga, ON, Canada.
¹⁰ Division of Critical Care Medicine, Department of Medicine, Montfort Hospital, Ottawa, ON, Canada.

Editorial

Michael A Austin et al. CJEM. 2025 Aug.

. 2025 Aug;27(8):578-579.

doi: 10.1007/s43678-025-00977-4.

Michael A Austin^{1

2

3

4}, Justin Godbout⁵, Andy Pan^{6

7

8

9

10}

¹ Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada. maustin@toh.ca.
² Ottawa Hospital Research Institute, Ottawa, ON, Canada. maustin@toh.ca.
³ Regional Paramedic Program for Eastern Ontario, Ottawa, ON, Canada. maustin@toh.ca.
⁴ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. maustin@toh.ca.
⁵ Department of Emergency Medicine, Queensway Carleton Hospital, Ottawa, ON, Canada.
⁶ Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada.
⁷ Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁸ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁹ ORNGE Transport Medicine, Mississauga, ON, Canada.
¹⁰ Division of Critical Care Medicine, Department of Medicine, Montfort Hospital, Ottawa, ON, Canada.

No abstract available

References

1. Kwong JL, Verbeek PR, Leong YC, et al. Paramedic use of ketamine for severe agitation and violence. Can J Emerg Med. 2025. https://doi.org/10.1007/s43678-025-00963-w . - DOI
1. Vilke GM, et al. Excited delirium syndrome (ExDS): defining based on review of the literature. J Forensic Leg Med. 2012. https://doi.org/10.1016/j.jemermed.2011.02.017 . - DOI
1. Colorado Department of Law. Investigation Report on the Death of Elijah McClain. Colorado State Attorney General’s Office, September 2021. https://coag.gov or through public records.
1. National Association of EMS Physicians (NAEMSP). Prehospital Ketamine Use for the Combative Patient—Webinar summary, November 6, 2020; Article Bites, April 21, 2022.
1. American Society of Anesthesiologists (ASA) & American College of Emergency Physicians (ACEP). Joint statement on the safe use of ketamine in prehospital care, August 26, 2020.