- Title
- Safety and effectiveness of high-dose midazolam for severe behavioural disturbance in an emergency department with suspected psychostimulant-affected patients
- Creator
- Spain, David; Crilly, Julia; Whyte, Ian; Jenner, Linda; Carr, Vaughan; Baker, Amanda
- Relation
- Emergency Medicine Australasia: EMA Vol. 20, Issue 2, p. 112-120
- Relation
- http://www3.interscience.wiley.com/journal/119425328/abstract
- Publisher
- Blackwell Publishing
- Resource Type
- journal article
- Date
- 2008
- Description
- Objectives: To trial high-dose midazolam sedation protocol for uncooperative patients with suspected psychostimulant-induced behavioural disorders. End-points were effectiveness and safety. Methods: A prospective pilot study was undertaken with a convenience sample of adult, uncooperative patients with suspected psychostimulant-induced severe behavioural disorders. The protocol was midazolam in 10 mg increments, i.m. or i.v., at 10 min intervals, up to four doses and titrated to an end-point of rousable drowsiness. Results: Sixty-two patients were enrolled. Two-thirds of the patients required only one dose of midazolam; 88% of the sample were sedated with two doses. Six and a half per cent of patients were not sedated after four doses. A Glasgow Coma Score of eight or less was prolonged in eight patients. Airway problems requiring an adjunct were present in four patients. Recent psychostimulant use was present in only 55% after full assessment. Conclusions: High-dose midazolam protocols cannot be supported as universally safe. High-dose protocols for severe behavioural disturbance are not more effective, with failures occurring even after repeated dosing.
- Subject
- emergency; midazolam; psychostimulant; behavioural disturbance
- Identifier
- uon:5065
- Identifier
- http://hdl.handle.net/1959.13/42931
- Identifier
- ISSN:1742-6731
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