The Safety and Effectiveness of Droperidol for Sedation of Acute Behavioral Disturbance in the Emergency Department

Calver, Leonie; Page, Colin B.; Downes, Michael A.; Chan, Betty; Kinnear, Frances; Wheatley, Luke; Spain, David; Isbister, Geoffrey K.

doi:10.1016/j.annemergmed.2015.03.016

Cited by 80 publications

(79 citation statements)

References 19 publications

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“…Furthermore, the publication of state health policies from both NSW and Queensland in 2015 may also have contributed to the observed changes in the prescribing pattern. In the present study, droperidol 10 mg was the most commonly prescribed dose, which is consistent with the dose used in several clinical studies . Although emerging data from observational studies show that ketamine appears to be effective in managing severely agitated patients, it was not commonly used in the participating EDs in this study.…”

Section: Discussionsupporting

confidence: 83%

“…In a survey conducted in 2009, midazolam was reported as the most preferred choice of parenteral sedation for agitation management among Australasian College of Emergency Medicine members, and it is the first‐line therapy recommended in the Therapeutic Guidelines for behavioural emergencies . The increasing number of studies documenting the efficacy and safety of droperidol in the Australian ED setting in the past 5 years may have reduced markedly the preference for midazolam. Furthermore, the publication of state health policies from both NSW and Queensland in 2015 may also have contributed to the observed changes in the prescribing pattern.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of behavioural emergencies: a prospective observational study in Australian emergency departments

Yap

Taylor

Kong

et al. 2019

Pharmacy Practice and Res

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Background Behavioural emergencies (BEs) are complex situations in the emergency department (ED) setting. Treatment decisions always must be made within a limited time and are based on incomplete patient data. As a result of the urgency and complexity, patients often are exposed to increased risk of harm. Aim The aim of this paper is to describe the prescribing patterns and adverse events (AEs) associated with parenteral sedation for the management of BEs in Australian EDs. Methods Ten Australian EDs enrolled a convenience sample of adult patients (aged ≥18 years) requiring parenteral sedative medication for BEs. Data were collected prospectively between March 2015 and April 2017 using a designated case report form. Results In all, 564 cases were enrolled in this study. Incomplete cases (n = 17; 3%) were excluded. Of the 547 remaining cases, 63% were male and the median age was 34 years (range 18–95 years). Approximately half the patients (n = 230; 42.1%) required mechanical restraint and parenteral sedation to manage their BEs. Intramuscular monotherapy was administered in most cases (n = 390; 71.3%). The main sedative medications used as monotherapy were droperidol (n = 381; 69.7%), midazolam (n = 54; 9.9%) and olanzapine (n = 26; 4.8%). The most common combination therapy was midazolam + droperidol (n = 36; 6.6%). The incidence of AEs from sedative administration was 13.5%. No deaths or irreversible AEs were reported. Conclusions Overall, the participating EDs provided safe pharmacological management for BEs. AEs following parenteral sedation are common, although serious AEs are rare. Because all patients receiving parenteral sedation for BEs are at risk of AEs, ongoing monitoring of vital signs after parenteral sedation should be a standard protocol in all EDs.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Management of behavioural emergencies: a prospective observational study in Australian emergency departments

Yap

Taylor

Kong

et al. 2019

Pharmacy Practice and Res

View full text Add to dashboard Cite

show abstract

“…This guideline was based on studies that demonstrated droperidol to be a safe and affective choice of sedation agent. As such it was recommended as the first‐ and second‐line agent to be used for this group of patients . In our study, droperidol was used 86% ( n = 149) of the time, indicating that clinicians are familiar with this drug and are compliant with the NSW guideline.…”

Section: Discussionmentioning

confidence: 74%

Impact of acutely behavioural disturbed patients in the emergency department: A prospective observational study

Oliver

Adonopulos

Haber

et al. 2018

Emerg Medicine Australasia

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“…In line with previous work conducted in the studied department and other departments, droperidol was the first‐line agent in all of these patients (Calver et al . , ).…”

Section: Discussionmentioning

confidence: 99%

Treatment and outcomes of patients presenting to an adult emergency department involuntarily with substance misuse

Hughes

Sheehan

Evans

2017

Int J Mental Health Nurs

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Alcohol and other drug (AOD) use is common in our society. The use of these substances flow throughout all areas of healthcare, and is especially prevalent in patients presenting to the emergency department with signs of mental illness. At the extreme end of these presentations patients present involuntarily with either police or ambulance officers. The aim of this study was to identify and describe the population presenting to the ED involuntarily with and without substance misuse as a precipitating factor. Quantitative descriptive analysis was used to describe this population between April and June 2015. In patients presenting to one large inner city emergency department involuntarily, 30% had alcohol or other drug misuse as a precipitating factor. Patients who involuntarily presented with alcohol and other misuse stay longer in the emergency department then others that do not have alcohol or other drug misuse. These patients represent frequently, with over 50% representing at 90 days however this was not associated with alcohol or other drug misuse. Almost all patients who present involuntarily are discharged home post review by a mental health team. Significant improvements in care can be made in this population if the opportunistic treatment of both mental illness and AOD misuse is completed in the emergency department.

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The Safety and Effectiveness of Droperidol for Sedation of Acute Behavioral Disturbance in the Emergency Department

Cited by 80 publications

References 19 publications

Management of behavioural emergencies: a prospective observational study in Australian emergency departments

Management of behavioural emergencies: a prospective observational study in Australian emergency departments

Impact of acutely behavioural disturbed patients in the emergency department: A prospective observational study

Treatment and outcomes of patients presenting to an adult emergency department involuntarily with substance misuse

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