Required Reports for Submission

These data collection forms will be utilized by all EMS Agencies licensed at the Advanced Life Support level when reviewing Ketamine or Etomidate administrations. Remember, if the agency is authorized to carry Ketamine or Etomidate but NOT have any administrations of these medications in a specific quarter, they are still required to submit the appropriate paperwork showing no utilization .

Reporting Requirements
EMS Agencies authorized to carry Ketamine or Etomidate are required to report those utilizations on a quarterly basis. All reporting must be completed by the 15th of the preceding month.

Sedation Assisted Intubation (Etomidate / Ketamine) Link

Sedation-assisted intubation may be appropriate for patients with compromised respiratory effort
and partially intact protective airway reflexes. Examples of appropriate criteria for sedation-assisted
intubation include:
1. Hypoxia (pulse oximetry < 90%) despite high flow oxygen by NRB mask or by CPAP.
2. Inability to protect airway.
3. Traumatic injury with GCS < 8 at the time of decision to intubate.

Sedation Assisted Intubation

Ketamine Administrations Link

Appropriate reasons for Ketamine administrations:

1. Delirium with Agitated Behavior
2. Non-Traumatic Pain Management
3. Musculoskeletal Trauma

Ketamine Administrations