Ketamine for Acute Suicidal Ideation in the Emergency Department: Randomized Controlled Trial

Exclusion Criteria

• •-Poor vital sign stability hypoxia: O2 \< 95%, hypotension: SBP\< 90 hypertension: SBP\>180 Heart rate: \< 50 or \>120 Respiratory Rate: \<10 or \>30
• •Altered mental status or intoxication
• •Patient is unwilling to participate or provide informed consent
• •Any allergy to ketamine or diphenhydramine
• •Patient is female of child-bearing age and unwilling to provide urine or blood for HCG analysis
• •Pregnancy or breast feeding
• •Presence of chronic oxygen-dependent pulmonary disease, liver cirrhosis, or renal disease requiring dialysis
• •Presence of ischemic heart disease, heart failure, or a history of unstable dysrhythmias
• •Presence of intracranial mass or vascular lesion.
• •Presence of a history of psychosis or hallucinations (as assessed by electronic chart review)
• •Weight greater than 115 kg or less than 45kg
• •History of increased intracranial pressure/hypertensive hydrocephalus
• •Non-English speaking patients
• •Patient is acutely psychotic
• •Provider feels that patient currently or likely will require chemical and/or physical restraints
• •History of prolonged QT-interval