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Conference Paper: Management of acute agitation in Australasian emergency departments: variations in practice

TitleManagement of acute agitation in Australasian emergency departments: variations in practice
Authors
Issue Date2011
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1742-6723
Citation
The 27th Annual Scientific Meeting of the Australasian College of Emergency Medicine (ACEM 2010), Canberra, Australia, 21-25 November 2010. In Emergency Medicine Australasia, 2011, v. 23 suppl. s1, p. 21 How to Cite?
AbstractINTRODUCTION: We aimed to describe current prescribing practice of emergency medicine clinicians in the management of highly agitated patients and to identify perceived barriers and gaps in training. METHODS: We undertook an anonymous cross-sectional mail survey of ACEM members between June and September, 2009. A questionnaire including a case vignette of a hypothetical patient and three clinical scenarios was employed. RESULTS: Of 2045 members surveyed 786 (38.4%) responses were received. Where no history was available, midazolam was the preferred monotherapy for 80.0% of respondents, followed by haloperidol (5.7%) and olanzapine (4.9%). Most respondents (500, 63.9%) would preferentially administer another sedative (combination therapy). The most common additional agents were haloperidol (238, 47.6%) olanzapine (100, 20.0%) and droperidol (82, 16.4%). The IV route was preferred for most drugs. The main reasons for using a combination were the differing mechanisms of action (437, 87.4%) and lower dosage requirements (289, 57.8%). Reported barriers to management included lack of both training (352, 44.9%) and national clinical guidelines (313, 40.0%). Respondents were generally confi dent in all aspects of management, though relatively fewer trainees were confi dent in determining dosing. Institutional guidelines were considered most useful for 415 (415/783, 53.0%) respondents. If an ACEM endorsed guideline were to be developed in the future, 634 (81.0%) respondents would consider this useful. CONCLUSIONS: There is considerable variation in the management of acute agitation in Australasian EDs. Benzodiazepines and antipsychotics, either alone or in combination are commonly used. An ACEM endorsed guideline is recommended.
DescriptionOral Programme Abstratcs
This FREE journal suppl. entitled: Special Issue: Abstracts of the 27th Annual Scientific Meeting of the Australasian College for Emergency Medicine, 21-25 November 2010, Canberra, ACT, Australia
Persistent Identifierhttp://hdl.handle.net/10722/204438
ISSN
2015 Impact Factor: 1.223
2015 SCImago Journal Rankings: 0.567

 

DC FieldValueLanguage
dc.contributor.authorKnott, JCen_US
dc.contributor.authorChan, EWYen_US
dc.contributor.authorTaylor, DMen_US
dc.contributor.authorKong, DCMen_US
dc.date.accessioned2014-09-19T23:52:04Z-
dc.date.available2014-09-19T23:52:04Z-
dc.date.issued2011en_US
dc.identifier.citationThe 27th Annual Scientific Meeting of the Australasian College of Emergency Medicine (ACEM 2010), Canberra, Australia, 21-25 November 2010. In Emergency Medicine Australasia, 2011, v. 23 suppl. s1, p. 21en_US
dc.identifier.issn1742-6731-
dc.identifier.urihttp://hdl.handle.net/10722/204438-
dc.descriptionOral Programme Abstratcs-
dc.descriptionThis FREE journal suppl. entitled: Special Issue: Abstracts of the 27th Annual Scientific Meeting of the Australasian College for Emergency Medicine, 21-25 November 2010, Canberra, ACT, Australia-
dc.description.abstractINTRODUCTION: We aimed to describe current prescribing practice of emergency medicine clinicians in the management of highly agitated patients and to identify perceived barriers and gaps in training. METHODS: We undertook an anonymous cross-sectional mail survey of ACEM members between June and September, 2009. A questionnaire including a case vignette of a hypothetical patient and three clinical scenarios was employed. RESULTS: Of 2045 members surveyed 786 (38.4%) responses were received. Where no history was available, midazolam was the preferred monotherapy for 80.0% of respondents, followed by haloperidol (5.7%) and olanzapine (4.9%). Most respondents (500, 63.9%) would preferentially administer another sedative (combination therapy). The most common additional agents were haloperidol (238, 47.6%) olanzapine (100, 20.0%) and droperidol (82, 16.4%). The IV route was preferred for most drugs. The main reasons for using a combination were the differing mechanisms of action (437, 87.4%) and lower dosage requirements (289, 57.8%). Reported barriers to management included lack of both training (352, 44.9%) and national clinical guidelines (313, 40.0%). Respondents were generally confi dent in all aspects of management, though relatively fewer trainees were confi dent in determining dosing. Institutional guidelines were considered most useful for 415 (415/783, 53.0%) respondents. If an ACEM endorsed guideline were to be developed in the future, 634 (81.0%) respondents would consider this useful. CONCLUSIONS: There is considerable variation in the management of acute agitation in Australasian EDs. Benzodiazepines and antipsychotics, either alone or in combination are commonly used. An ACEM endorsed guideline is recommended.-
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1742-6723-
dc.relation.ispartofEmergency Medicine Australasiaen_US
dc.titleManagement of acute agitation in Australasian emergency departments: variations in practiceen_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, EWY: ewchan@hku.hken_US
dc.identifier.authorityChan, EWY=rp01587en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/j.1742-6723.2011.01364.x-
dc.identifier.hkuros233745en_US
dc.identifier.volume23-
dc.identifier.issuesuppl. s1-
dc.identifier.spage21-
dc.identifier.epage21-
dc.publisher.placeAustralia-
dc.customcontrol.immutablesml 160629 amended-

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