In:
Journal of Pharmacy Practice and Research, Wiley, Vol. 49, No. 4 ( 2019-08), p. 341-348
Abstract:
Behavioural emergencies (BEs) are complex situations in the emergency department (ED) setting. Treatment decisions always must be made within a limited time and are based on incomplete patient data. As a result of the urgency and complexity, patients often are exposed to increased risk of harm. Aim The aim of this paper is to describe the prescribing patterns and adverse events ( AE s) associated with parenteral sedation for the management of BE s in Australian ED s. Methods Ten Australian ED s enrolled a convenience sample of adult patients (aged ≥18 years) requiring parenteral sedative medication for BE s. Data were collected prospectively between March 2015 and April 2017 using a designated case report form. Results In all, 564 cases were enrolled in this study. Incomplete cases ( n = 17; 3%) were excluded. Of the 547 remaining cases, 63% were male and the median age was 34 years (range 18–95 years). Approximately half the patients ( n = 230; 42.1%) required mechanical restraint and parenteral sedation to manage their BE s. Intramuscular monotherapy was administered in most cases ( n = 390; 71.3%). The main sedative medications used as monotherapy were droperidol ( n = 381; 69.7%), midazolam ( n = 54; 9.9%) and olanzapine ( n = 26; 4.8%). The most common combination therapy was midazolam + droperidol ( n = 36; 6.6%). The incidence of AE s from sedative administration was 13.5%. No deaths or irreversible AE s were reported. Conclusions Overall, the participating ED s provided safe pharmacological management for BE s. AE s following parenteral sedation are common, although serious AE s are rare. Because all patients receiving parenteral sedation for BE s are at risk of AE s, ongoing monitoring of vital signs after parenteral sedation should be a standard protocol in all ED s.
Type of Medium:
Online Resource
ISSN:
1445-937X
,
2055-2335
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2576048-8
SSG:
15,3