Casey Patrick

Much of prehospital seizure management, rightfully so, focuses on benzodiazepines/midazolam as our primary pharmacological choice in the field. What are our options when midazolam doesn’t work, and how often does that even happen? This session will define “refractory status epileptics” and discuss recent evidence supporting an old familiar friend for assistance when benzos fail.

Another ketamine presentation, really? News flash, EMS is under the ketamine microscope.

Far too often, we zoom into the ketamine specifics: NMDA action and pharmacology, what about ketamine versus etomidate for intubation induction, ketamine versus narcotics for prehospital analgesia, and so on. This presentation will zoom out from all the ketamine specific indications and use cases and address the "total package" for safe ketamine use in patients with severe agitation. What should our clinical, quality, education, and training programs look like? Is there a minimum framework necessary to utilize ketamine safely in EMS in 2026? We will share emerging research, actual high-risk EMS cases, and future pathways to address the question of "safe" ketamine use in EMS.