- Title
- Parenteral sedation of elderly patients with acute behavioral disturbance in the ED
- Creator
- Calver, Leonie; Isbister, Geoffrey K.
- Relation
- American Journal of Emergency Medicine Vol. 31, Issue 6, p. 970-973
- Publisher Link
- http://dx.doi.org/10.1016/j.ajem.2013.03.026
- Publisher
- W. B. Saunders
- Resource Type
- journal article
- Date
- 2013
- Description
- Purposes: This study aimed to investigate sedation of elderly patients with acute behavioral disturbance (ABD) in the emergency department (ED), specifically the safety and effectiveness of droperidol. Basic Procedures: This was a prospective study of elderly patients (> 65 years) with ABD requiring parenteral sedation and physical restraint in the ED. Patients were treated with a standardized sedation protocol that included droperidol. Drug administration, time to sedation, additional sedation, and adverse effects were recorded. Effective sedation was defined as a drop in the sedation assessment tool score by 2 or a score of zero or less. Main Findings: There were 49 patients with median age of 81 years (range, 65-93 years); 33 were males. Thirty patients were given 10 mg droperidol, 15 were given 5 mg droperidol, 2 were given 2.5 mg, and 2 were given midazolam. Median time to sedation for patients receiving 10 mg droperidol was 30 minutes (interquartile range, 18-40 minutes), compared with 21 minutes (interquartile range, 10-55 minutes; P = .55) for patients receiving 5 mg droperidol. Three patients were not sedated within 120 minutes. Eighteen patients required additional sedation—10 of 30 (33%; 95% confidence interval, 18%-53%) given droperidol 10 mg compared with 7 of 15 (47%; 95% confidence interval, 22%-73%) given 5 mg. Fourteen patients required resedation. Adverse effects occurred in 5 patients (hypotension [2], oversedation [2], hypotension/oversedation [1])—2 of 30 given 10 mg droperidol and 3 of 19 not treated according to protocol. Midazolam was given initially or for additional sedation in 2 of 5 adverse effects. No patient had QT prolongation. Principal Conclusions: Droperidol was effective for sedation in most elderly patients with ABD, and adverse effects were uncommon. An initial 5-mg dose appears prudent with the expectation that many will require another dose.
- Subject
- acute behavioral disturbance; sedation; elderly patients; drug administration
- Identifier
- http://hdl.handle.net/1959.13/1045891
- Identifier
- uon:14539
- Identifier
- ISSN:0735-6757
- Language
- eng
- Full Text
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