Ketamine versus propofol in sedation of psychiatric patients requiring retrieval

In this study, we will compare the safety and effectiveness of ketamine and propofol in sedating acute psychiatric patients needing aeromedical retrieval. We believe that this is the first trial of its kind which will elucidate the complications, the safety profile and effectiveness of the two drugs in sedating acute psychiatric patients. The study will be a prospective, open-labelled, randomised controlled trial. Patients will be drawn the Northern Territory and Queensland. Through this study, we will better inform clinicians in their choice of a suitable sedation agent and potential provide an additional sedation choice in aeromedical and other critical care environments. Furthermore, this research has the potential to establish sedation guidelines in the aeromedical retrieval of acute psychiatric patients for Australia and internationally.

The Queensland Aeromedical Retrieval System: A Review of Current Status and the Impact of State-wide System Developments.

Aeromedical retrievals and transfers are an essential component of modern Emergency Medicine. These services provide high quality emergency care to the patient and facilitate transport from the roadside or smaller hospitals to larger centres able to perform potentially life saving treatments and provide definitive care. Thus they help ensure equity of access to high quality medical care regardless of physical isolation. This is especially important in Queensland, the most decentralised Australian state.

Until recently aeromedical clinical coordination and retrieval services in Queensland were provided by a several different organizations. In 2005 a system restructure was commenced and a state-wide centralised Queensland Emergency Medical System (QEMS) Clinical Coordination Centre and dedicated medical retrieval and transfer service was established. Standardised retrieval service data has been collected centrally since February 2007 with over 18,000 patients transported each year.

The project will review in detail five years of state-wide aeromedical retrieval system activity to describe the nature and extent of services provided.