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Droperidol and midazolam, alone or combined, have similar effects on duration of violent and acute behaviour disturbance in emergency department patients

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Question

Question

Which drug is most effective at sedation of violent or agitated patients in the emergency department: midazolam, droperidol or a combination of the two?

Patients

79 adults presenting on 91 occasions with violent and acute behavioural disturbance of sufficient severity to require restraint and sedation, as assessed by clinic staff. No exclusions were made on the grounds of suspected cause of behaviour. Most presentations related to alcohol intoxication (70%), 41% were related to deliberate self harm, 9% to drug induced delirium, 5% to acute psychosis and 2% to other causes.

Setting

One urban hospital emergency department, Australia; August 2008 to July 2009.

Intervention

10 mg midazolam (29 patients), 10 mg droperidol (33 patients) or 5 mg midazolam plus 5 mg droperidol (29 patients), administered by intramuscular injection.

Outcomes

Primary outcome: duration of the violent and acute behavioural disturbance episode (defined as the duration of need for attendance of security staff to assist management of the patient). Secondary outcomes: included necessity for additional sedation and occurrence of adverse …

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