PMID- 29558224
OWN - NLM
STAT- MEDLINE
DCOM- 20190607
LR  - 20191210
IS  - 1545-0066 (Electronic)
IS  - 1090-3127 (Linking)
VI  - 22
IP  - 6
DP  - 2018 Nov-Dec
TI  - A Prospective Before and After Study of Droperidol for Prehospital Acute 
      Behavioral Disturbance.
PG  - 713-721
LID - 10.1080/10903127.2018.1445329 [doi]
AB  - STUDY OBJECTIVE: Acute behavioral disturbance is a common problem for emergency 
      medical services. We aimed to investigate the safety and effectiveness of 
      droperidol compared to midazolam in the prehospital setting. METHODS: This was a 
      prospective before and after study comparing droperidol to midazolam for 
      prehospital acute behavioral disturbance, when the state ambulance service 
      changed medications. The primary outcome was the proportion of adverse effects 
      (airway intervention, oxygen saturation < 90%, respiratory rate < 12, systolic 
      blood pressure < 90 mmHg, sedation assessment tool score -3 and dystonic 
      reactions) in patients receiving sedation. Secondary outcomes included time to 
      sedation, requirement for additional sedation, staff and patient injuries, and 
      prehospital time. RESULTS: There were 141 patients administered midazolam and 149 
      patients administered droperidol in the study. Alcohol was the most common cause 
      of acute behavioral disturbance. Fewer patient adverse events occurred with 
      droperidol (11/149) compared to midazolam (33/141) (7% vs. 23%; absolute 
      difference 16%; 95% confidence interval [CI]: 8% to 24%; p = 0.0001). Median time 
      to sedation was 22 min (interquartile range [IQR]:18 to 35 min) for droperidol 
      compared to 30 min (IQR:20 to 45 min) for midazolam. Additional prehospital 
      sedation was required in 6/149 (4%) droperidol patients and 20/141 (14%) 
      midazolam patients, and 11 (7%) droperidol and 59 (42%) midazolam patients 
      required further sedation in the emergency department. There were no differences 
      in patient or staff injuries, or prehospital time. CONCLUSIONS: The use of 
      droperidol for acute behavioral disturbance in the prehospital setting is 
      associated with fewer adverse events, a shorter time to sedation, and fewer 
      requirements for additional sedation.
FAU - Page, Colin B
AU  - Page CB
FAU - Parker, Lachlan E
AU  - Parker LE
FAU - Rashford, Stephen J
AU  - Rashford SJ
FAU - Bosley, Emma
AU  - Bosley E
FAU - Isoardi, Katherine Z
AU  - Isoardi KZ
FAU - Williamson, Frances E
AU  - Williamson FE
FAU - Isbister, Geoffrey K
AU  - Isbister GK
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180320
PL  - England
TA  - Prehosp Emerg Care
JT  - Prehospital emergency care
JID - 9703530
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Hypnotics and Sedatives)
RN  - O9U0F09D5X (Droperidol)
RN  - R60L0SM5BC (Midazolam)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antipsychotic Agents/*administration & dosage
MH  - Attention Deficit and Disruptive Behavior Disorders/*drug therapy
MH  - Droperidol/*administration & dosage
MH  - *Emergency Medical Services
MH  - Emergency Service, Hospital
MH  - Female
MH  - Humans
MH  - Hypnotics and Sedatives/*administration & dosage
MH  - Male
MH  - Midazolam/*administration & dosage
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - acute behavioral disturbance
OT  - chemical sedation
OT  - prehospital
EDAT- 2018/03/21 06:00
MHDA- 2019/06/08 06:00
CRDT- 2018/03/21 06:00
PHST- 2018/03/21 06:00 [pubmed]
PHST- 2019/06/08 06:00 [medline]
PHST- 2018/03/21 06:00 [entrez]
AID - 10.1080/10903127.2018.1445329 [doi]
PST - ppublish
SO  - Prehosp Emerg Care. 2018 Nov-Dec;22(6):713-721. doi: 
      10.1080/10903127.2018.1445329. Epub 2018 Mar 20.