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WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? This case report demonstrates that it is possible that foreign material within the ILMA can make successful intubation impossible, despite successful placement and ventilation through the device. Maneuvers may be performed to attempt successful ET intubation, but when unsuccessful, removal of the ILMA and alternate airway management must be performed. BACKGROUND Ketamine's application in psychiatry have expanded, but it appears never to have been previously used to diagnose and treat p