File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Variation in the management of hypothetical cases of acute agitation in Australasian emergency departments

TitleVariation in the management of hypothetical cases of acute agitation in Australasian emergency departments
Authors
KeywordsAggression
Emergency medicine
Pharmaceutical preparation
Questionnaire
Violence
Issue Date2011
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/EMA
Citation
Ema - Emergency Medicine Australasia, 2011, v. 23 n. 1, p. 23-32 How to Cite?
AbstractObjective: To describe the prescribing practice of emergency medicine clinicians in the management of highly agitated patients and to identify perceived barriers to management and the gaps in training. Method: We undertook an anonymous cross-sectional mail survey of the Australasian College for Emergency Medicine (ACEM) members (fellows and advanced trainees) between June and September 2009. A questionnaire including a case vignette of a hypothetical patient and three clinical scenarios was employed to ascertain prescribing practice and assess perceived barriers to management, confidence and the perceived usefulness of existing and future Clinical Practice Guidelines (CPGs). Results: All 2052 ACEM members were surveyed. However, seven had incorrect postal addresses and could not be reached. Of the remaining 2045, 786/2052 (38.3%, 95% CI 36.2-40.5) responses were received. Of the 786 respondents, 783 were practicing clinicians. If monotherapy was chosen, 622/783 (79.4%, 95% CI 76.4-82.2) of respondents preferred midazolam to manage the common scenario where no history was available, followed by haloperidol 45/783 (5.8%, 95% CI 4.3-7.7) and olanzapine 38/783 (4.9%, 95% CI 3.5-6.7). Most respondents 500/783 (63.9%, 95% CI 60.4-67.2) would also administer another sedative (combination therapy). Important perceived barriers to agitation management included lack of both training (352/783 [45.0%, 95% CI 41.4-48.5]) and a national CPG (313/783 [40.0%, 95% CI 36.5-43.5]). Respondents were generally confident in all aspects of management, although relatively fewer trainees were confident in determining dosing. Institutional CPGs were considered most useful for 415/783 (53.0%, 95% CI 49.4-56.5) respondents. If an ACEM-endorsed CPG were to be developed in the future, 634/783 (81.0%, 95% CI 78.0-83.6) respondents would consider this useful. Conclusion: There is considerable variation in the management of hypothetical cases of acute agitation in Australasian EDs. Benzodiazepines and antipsychotics, either alone or in combination, are commonly used. An ACEM-endorsed, Australasian CPG was perceived as useful. © 2010 The Authors. EMA © 2010 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Persistent Identifierhttp://hdl.handle.net/10722/145477
ISSN
2015 Impact Factor: 1.223
2015 SCImago Journal Rankings: 0.567
ISI Accession Number ID
Funding AgencyGrant Number
Australian Rotary Heath Research Fund
Funding Information:

EWC was supported by an Ian Scott PhD scholarship from the Australian Rotary Heath Research Fund.

References

 

DC FieldValueLanguage
dc.contributor.authorChan, EWYen_HK
dc.contributor.authorTaylor, DMen_HK
dc.contributor.authorKnott, JCen_HK
dc.contributor.authorKong, DCMen_HK
dc.date.accessioned2012-02-23T12:11:06Z-
dc.date.available2012-02-23T12:11:06Z-
dc.date.issued2011en_HK
dc.identifier.citationEma - Emergency Medicine Australasia, 2011, v. 23 n. 1, p. 23-32en_HK
dc.identifier.issn1742-6731en_HK
dc.identifier.urihttp://hdl.handle.net/10722/145477-
dc.description.abstractObjective: To describe the prescribing practice of emergency medicine clinicians in the management of highly agitated patients and to identify perceived barriers to management and the gaps in training. Method: We undertook an anonymous cross-sectional mail survey of the Australasian College for Emergency Medicine (ACEM) members (fellows and advanced trainees) between June and September 2009. A questionnaire including a case vignette of a hypothetical patient and three clinical scenarios was employed to ascertain prescribing practice and assess perceived barriers to management, confidence and the perceived usefulness of existing and future Clinical Practice Guidelines (CPGs). Results: All 2052 ACEM members were surveyed. However, seven had incorrect postal addresses and could not be reached. Of the remaining 2045, 786/2052 (38.3%, 95% CI 36.2-40.5) responses were received. Of the 786 respondents, 783 were practicing clinicians. If monotherapy was chosen, 622/783 (79.4%, 95% CI 76.4-82.2) of respondents preferred midazolam to manage the common scenario where no history was available, followed by haloperidol 45/783 (5.8%, 95% CI 4.3-7.7) and olanzapine 38/783 (4.9%, 95% CI 3.5-6.7). Most respondents 500/783 (63.9%, 95% CI 60.4-67.2) would also administer another sedative (combination therapy). Important perceived barriers to agitation management included lack of both training (352/783 [45.0%, 95% CI 41.4-48.5]) and a national CPG (313/783 [40.0%, 95% CI 36.5-43.5]). Respondents were generally confident in all aspects of management, although relatively fewer trainees were confident in determining dosing. Institutional CPGs were considered most useful for 415/783 (53.0%, 95% CI 49.4-56.5) respondents. If an ACEM-endorsed CPG were to be developed in the future, 634/783 (81.0%, 95% CI 78.0-83.6) respondents would consider this useful. Conclusion: There is considerable variation in the management of hypothetical cases of acute agitation in Australasian EDs. Benzodiazepines and antipsychotics, either alone or in combination, are commonly used. An ACEM-endorsed, Australasian CPG was perceived as useful. © 2010 The Authors. EMA © 2010 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.en_HK
dc.languageengen_US
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/EMAen_HK
dc.relation.ispartofEMA - Emergency Medicine Australasiaen_HK
dc.subjectAggressionen_HK
dc.subjectEmergency medicineen_HK
dc.subjectPharmaceutical preparationen_HK
dc.subjectQuestionnaireen_HK
dc.subjectViolenceen_HK
dc.titleVariation in the management of hypothetical cases of acute agitation in Australasian emergency departmentsen_HK
dc.typeArticleen_HK
dc.identifier.emailChan, EWY: ewchan@hku.hken_HK
dc.identifier.authorityChan, EWY=rp01587en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1742-6723.2010.01348.xen_HK
dc.identifier.pmid21091874-
dc.identifier.scopuseid_2-s2.0-79551502789en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79551502789&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume23en_HK
dc.identifier.issue1en_HK
dc.identifier.spage23en_HK
dc.identifier.epage32en_HK
dc.identifier.eissn1742-6723-
dc.identifier.isiWOS:000286888500005-
dc.publisher.placeAustraliaen_HK
dc.identifier.scopusauthoridChan, EWY=14043219000en_HK
dc.identifier.scopusauthoridTaylor, DM=35512837000en_HK
dc.identifier.scopusauthoridKnott, JC=7102964211en_HK
dc.identifier.scopusauthoridKong, DCM=7202350808en_HK
dc.identifier.citeulike8788476-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats