Ketamine Versus Midazolam for Prehospital Agitation

This research study is being done to figure out the best approach to treatment of
pre-hospital agitation. It will compare two tiered dosing treatment protocols, one
ketamine-based and one midazolam-based. Agitation is a state of extreme emotional disturbance
where patients can become physically aggressive or violent, endangering themselves and those
who are caring for them. Often chemical substances or severe mental illness are involved in
this level of agitation. Specifically, the investigators are interested in studying agitation
that is treated in the prehospital setting by paramedics. This study's hypothesis is a
ketamine-based protocol will achieve a faster time to adequate sedation than a
midazolam-based protocol for treatment of agitation in the prehospital environment. This
study will observe the natural history of an emergency medical services standard operating
procedure change from a ketamine-based protocol to a midazolam-based protocol.