Emergency physicians regularly encounter agitated patients that are a risk to both health care providers and themselves.  The onset of many traditional medications is relatively slow and often requires additional doses.  Although there haven’t been large numbers of studies, the use of ketamine to control the acutely agitated patient has been increasing both in the prehospital and ED settings. Its characteristics such as rapid onset, preservation of respiratory drive, and minimal hemodynamic effects make it potentially desirable as a first-dose control agent.  In this post, we walk through some of the literature on the use of ketamine for the acutely agitated patient.