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Which drug is most effective at sedation of violent or agitated patients in the emergency department: midazolam, droperidol or a combination of the two?
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.
One urban hospital emergency department, Australia; August 2008 to July 2009.
10 mg midazolam (29 patients), 10 mg droperidol (33 patients) or 5 mg midazolam plus 5 mg droperidol (29 patients), administered by intramuscular injection.
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 drug reactions. Bayesian time to event analyses was used …
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