Prospective study of the safety and effectiveness of droperidol in elderly patients for pre-hospital acute behavioural disturbance

Colin B. Page, Lachlan E. Parker, Stephen J. Rashford, Sanjeewa Kulawickrama, Katherine Z. Isoardi, Geoffrey K. Isbister*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)731-736
Number of pages6
JournalEMA - Emergency Medicine Australasia
Volume32
Issue number5
DOIs
Publication statusPublished - 1 Oct 2020

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