An audit of a change in clinical practice for Queensland Ambulance Service from midazolam to droperidol for patients with prehospital acute behavioural disturbance.

An audit of a change in clinical practice for Queensland Ambulance Service from midazolam to droperidol for prehospital acute behavioural disturbance.

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12616001489482

Enrollment

290

Registered

2016-10-26

Start date

2016-05-28

Completion date

2017-05-24

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

The Queensland Ambulance Service (QAS) is changing its drug management of acute behavioural disturbance (ABD) from midazolam to droperidol based on the research undertaken by the chief investigator (Page) and one of the principle investigators (Isbister) in the emergency department setting. New South Wales ambulance service has undertaken this change in 2015. Auditing to date of the QAS ambulance report form (ARF) use of midazolam demonstrates poor use of sedation scores, missing information & adverse effects from midazolam. It is therefore planed to audit this change over in drug management with an audit form in addition to standard reporting (ARF). This will be a prospective observational study, as part of a quality assurance monitoring process of this changeover looking at effectiveness and safety of both agents. Possible outcomes will hopefully be a more effective and safer management of this condition.

Interventions

Patients with acute behavioural disturbance (ABD) managed by the Queensland Ambulance Service (QAS) are currently administered midazolam for their drug management. The QAS are replacing midazolam for droperidol in the drug management of ABD. We want to study this change in practice by QAS of these 2 drugs on there effectiveness and safety for the management of ABD. Date for implementation for the change over to droperidol is 15th November 2016. The audit period will run from this date until we have collected 130 patients who have received droperidol. It is expected that this will be reached by the 15th June 2017. The source of the data for the study will be from a combination of the standard reporting form for QAS (eARF) and a purpose built audit form. The regimen for droperidol is 10mg intramuscularly (IM) which can be repeated if the patient has not settled after 15 minutes to a total of 20mg. For patients >65 years the dose is 5mg IM which can be repeated if the patient has not settled after 15 minutes to a total dose of 10mg. The definition of settled is a reduction in the sedation assessment tool (SAT) score to 0 or lower or a reduction of 2 if the SAT score is 3. The follow up period once the patient has settled is for 1 hour to assess the requirement for any re sedation.

Eligibility

Sex/Gender

All

Age

16 Years to No maximum

Healthy volunteers

Inclusion criteria

1. Patients presenting with ABD 16 years of age and greater with a sedation assessment tool (SAT) score of 2 and 3.

Exclusion criteria

1. Patients presenting with ABD less than 16 years of age. 2. Patients with known adverse effects e.g. dystonic reaction or known allergy to droperidol or midazolam. 3. Patients with Parkinson’s disease.

Outcome results