- Title
- Prospective study of the safety and effectiveness of droperidol in elderly patients for pre-hospital acute behavioural disturbance
- Creator
- Page, Colin B.; Parker, Lachlan E.; Rashford, Stephen J.; Kulawickrama, Sanjeewa; Isoardi, Katherine Z.; Isbister, Geoffrey K.
- Relation
- NHMRC.ID1061041 http://purl.org/au-research/grants/nhmrc/1061041
- Relation
- Emergency Medicine Australasia Vol. 32, Issue 5, p. 731-736
- Publisher Link
- http://dx.doi.org/10.1111/1742-6723.13496
- Publisher
- John Wiley & Sons
- Resource Type
- journal article
- Date
- 2020
- Description
- Objective: Acute behavioural disturbance in the elderly (=65 years) is a significant issue for emergency medical services with increasing prevalence of dementia and aging populations. We investigated the pre-hospital safety and effectiveness of droperidol in the elderly with acute behavioural disturbance. Methods: This was a pre-hospital prospective observational 1-year study of elderly patients with acute behavioural disturbance. The primary outcome was proportion of adverse events (AEs) (airway intervention, oxygen saturation '90% and/or respiratory rate '12/min, systolic blood pressure '90 mmHg, sedation assessment tool score of -3 and dystonic reactions). Secondary outcomes included time to sedation, additional sedation, proportion with successful sedation. Results: There were 149 patients (males 78 [52%], median age 78 years; 65-101 years) presenting on 162 occasions. Dementia was the commonest cause (107/164 [65%]) of acute behavioural disturbance. There were six AEs in five patients (5/162 [3%]; 95% confidence interval 1-7). Three had hypotension, one with associated hypoxia (80%); and two had respiratory AEs (respiratory rate, 10/min [no hypoxia] and hypoxia [88%] which required oxygen). Median time to sedation was 19 min (interquartile range 12-29 min). Additional sedation was given in 2/162 patients during ambulance transfer and 16/162 within an hour of hospital arrival; 24/162 (15%) failed to sedate in the ambulance; 16 subsequently settled in ED and 8/24 received additional sedation. Of 162, 123 (76%) patients successfully sedated, without AEs or additional sedation. Of 162, 114 (70%) patients received 5 mg, 46 (29%) received two doses of 5 mg and two patients (1%) received three doses. Conclusions: Droperidol appeared to be safe and effective for pre-hospital sedation of acute behavioural disturbance in elderly patients.
- Subject
- acute behavioural disturbance; chemical sedation; elderly; pre-hospital
- Identifier
- http://hdl.handle.net/1959.13/1447512
- Identifier
- uon:43173
- Identifier
- ISSN:1742-6731
- Language
- eng
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