TY - JOUR
T1 - Prospective study of the safety and effectiveness of droperidol in elderly patients for pre-hospital acute behavioural disturbance
AU - Page, Colin B.
AU - Parker, Lachlan E.
AU - Rashford, Stephen J.
AU - Kulawickrama, Sanjeewa
AU - Isoardi, Katherine Z.
AU - Isbister, Geoffrey K.
N1 - Funding Information:
The authors acknowledge the assistance and support of the Queensland Ambulance Service staff. CBP was funded by an Emergency Medicine Foundation Research Fellowship. GKI is funded by an NHMRC Senior Research Fellowship ID1061041.
Publisher Copyright:
© 2020 Australasian College for Emergency Medicine
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85082338022&partnerID=8YFLogxK
U2 - 10.1111/1742-6723.13496
DO - 10.1111/1742-6723.13496
M3 - Article
C2 - 32216048
AN - SCOPUS:85082338022
SN - 1742-6731
VL - 32
SP - 731
EP - 736
JO - EMA - Emergency Medicine Australasia
JF - EMA - Emergency Medicine Australasia
IS - 5
ER -