ArticleBMC emergency medicine2010
The impact of a standardised intramuscular sedation protocol for acute behavioural disturbance in the emergency department.
Article in BMC emergency medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Organisational interventions for preventing and minimising aggression directed towards healthcare workers by patients and patient advocates.The Cochrane database of systematic reviews · 2020Pooled it
- National survey of Dutch emergency physicians on pharmacological sedation practices for extreme agitation.Toxicology reports · 2026Article
- A retrospective cohort study of pre-hospital agitation management by advanced paramedic practitioners in critical care.British paramedic journal · 2022Article
- Factors associated with paediatric and adolescent Emergency Department presentations involving acute behavioural disturbance events.Journal of paediatrics and child health · 2022Article
- Rapid agitation control with ketamine in the emergency department (RACKED): a randomized controlled trial protocol.Trials · 2018Article
- Mechanical restraint in an emergency department: a consecutive series of 593 cases.Internal and emergency medicine · 2018Article
- Population pharmacokinetics of intramuscular droperidol in acutely agitated patients.British journal of clinical pharmacology · 2016Article
- High dose droperidol and QT prolongation: analysis of continuous 12-lead recordings.British journal of clinical pharmacology · 2014Article
- A prospective study of high dose sedation for rapid tranquilisation of acute behavioural disturbance in an acute mental health unit.BMC psychiatry · 2013Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute behavioural disturbance (ABD) is an increasing problem in emergency departments. This study aimed to determine the impact of a structured intramuscular (IM) sedation protocol on the duration of ABD in the emergency department.
methodsA historical control study was undertaken comparing 58 patients who required physical restraint and parenteral sedation with the structured IM sedation protocol, to 73 historical controls treated predominantly by intravenous sedation, according to individual clinician preference. The primary outcome was the duration of the ABD defined as the time security staff were required. Secondary outcomes were the requirement for additional sedation, drug related-adverse effects and patient and staff injuries.
resultsThe median duration of the ABD in patients with the new sedation protocol was 21 minutes (IQR: 15 to 35 minutes; Range: 5 to 78 minutes) compared to a median duration of 30 minutes (IQR: 15 to 50 minutes; Range: 5 to 135 minutes) in the historical controls which was significantly different (p = 0.03). With IM sedation only 27 of 58 patients (47%; 95% CI: 34% to 60%) required further sedation compared to 64 of 73 historical controls (88%; 95%CI: 77% to 94%). There were six (10%) drug-related adverse events with the new IM protocol [oxygen desaturation (5), oxygen desaturation/airway obstruction (1)] compared to 10 (14%) in the historical controls [oxygen desaturation (5), hypoventilation (4) and aspiration (1)]. Injuries to staff occurred with three patients using the new sedation protocol and in seven of the historical controls. Two patients were injured during the new protocol and two of the historical controls.
conclusionThe use of a standardised IM sedation protocol was simple, more effective and as safe for management of ABD compared to predominantly intravenous sedation.
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