Chemical sedation of excited delirium in the pre-hospital setting.

A 30-year-old male presents to emergency medical services profoundly combative with a Richmond Agitation-Sedation Scale of +4 after reported use of intravenous methamphetamines. A preliminary diagnosis of excited delirium syndrome is made based on the history obtained and the decision is made to chemically sedate the patient. While preparing for sedation, you wonder which pharmacological agent will produce the fastest and safest sedation in this patient population.