Parenteral medication for the management of acute severe behavioural disturbance (ASBD) in the emergency department
- PMID: 39908073
- PMCID: PMC11134519
- DOI: 10.1002/14651858.CD014826
Parenteral medication for the management of acute severe behavioural disturbance (ASBD) in the emergency department
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety profiles of different parenteral medications for the management of acute severe behavioural disturbance in the emergency department setting. These medications are required following the failure of less restrictive means of controlling the patient's behavioural disturbance.
Copyright © 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
Elyssia Bourke: University of Melbourne/National Health and Medical Research Council (NHMRC) related to investigating acute severe behavioural disturbance
Kate Klein: none known
Jonathan Knott: none known
Simon Craig: Medical Research Future's Fund Grant related to paediatric mental health and acute severe behavioural disturbance
Emma Tavender: none known
Franz Babl: none known
Similar articles
-
Antidepressants for pain management in adults with chronic pain: a network meta-analysis.Health Technol Assess. 2024 Oct;28(62):1-155. doi: 10.3310/MKRT2948. Health Technol Assess. 2024. PMID: 39367772 Free PMC article.
-
The Effectiveness of Ketamine Compared to Opioid Analgesics for management of acute pain in Children in The Emergency Department: systematic Review.Am J Emerg Med. 2022 Nov;61:143-151. doi: 10.1016/j.ajem.2022.08.004. Epub 2022 Aug 13. Am J Emerg Med. 2022. PMID: 36113377
-
Antipsychotic reduction and/or cessation and antipsychotics as specific treatments for tardive dyskinesia.Cochrane Database Syst Rev. 2018 Feb 6;2(2):CD000459. doi: 10.1002/14651858.CD000459.pub3. Cochrane Database Syst Rev. 2018. PMID: 29409162 Free PMC article.
-
Behavioural interventions for smoking cessation: an overview and network meta-analysis.Cochrane Database Syst Rev. 2021 Jan 4;1(1):CD013229. doi: 10.1002/14651858.CD013229.pub2. Cochrane Database Syst Rev. 2021. PMID: 33411338 Free PMC article.
-
Olanzapine IM or velotab for acutely disturbed/agitated people with suspected serious mental illnesses.Cochrane Database Syst Rev. 2005 Apr 18;2005(2):CD003729. doi: 10.1002/14651858.CD003729.pub2. Cochrane Database Syst Rev. 2005. PMID: 15846678 Free PMC article.
Cited by
-
Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings.Clin Pract. 2025 Jun 16;15(6):112. doi: 10.3390/clinpract15060112. Clin Pract. 2025. PMID: 40558230 Free PMC article.
References
Additional references
Bellolio 2016
Bernard 2021
-
- Bernard S, Roggenhamp R, Delorenzo A, Stephenson M, Smith K. Use of intramuscular ketamine by paramedics in the management of severely agitated patients. Emergency Medicine Australasia 2021;33(5):875-82. [PMID: ] - PubMed
Bourke 2021
-
- Bourke EM, Say DF, Carison A, Hill A, Craig S, Hiscock H, et al. Emergency mental health presentations in children with autism spectrum disorder and attention deficit hyperactivity disorder. Journal of Paediatrics and Child Health 2021;57(10):1572-9. - PubMed
Calver 2011
-
- Calver LA, Stokes B, Isbister GK. Sedation assessment tool to score acute behavioural disturbance in the emergency department: The sedation assessment tool. Emergency Medicine Australasia 2011;23(6):732-40. [PMID: ] - PubMed
Calver 2012
-
- Calver L, Isbister G. Dexmedetomidine in the emergency department: assessing safety and effectiveness in difficult-to-sedate acute behavioural disturbance. Emergency Medicine Journal 2012;29(11):915-8. [PMID: ] - PubMed
Campo‐Soria 2006
Carison 2020
-
- Carison A, Babl FE, Hill A, O’Donnell SM. Children and adolescents with severe acute behavioural disturbance in the emergency department. Emergency Medicine Australasia 2020;32(5):747-55. [PMID: ] - PubMed
Cepaityte 2021
-
- Cepaityte D, Siafis S, Papazisis G. Safety of antipsychotic drugs: a systematic review of disproportionality analysis studies. Behavioural Brain Research 2021;404:113168. [PMID: ] - PubMed
Chan 2013
-
- Chan EW, Taylor DM, Knott JC, Phillips GA, Castle DJ, Kong DCM. Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial. Annals of Emergency Medicine 2013;61(1):72-81. [PMID: ] - PubMed
Church 2013
Cookson 2019
-
- Cookson J. Histamine in psychiatry: promethazine as a sedative anticholinergic. British Journal of Psychiatry Advances 2019;25(4):265-8. [DOI: 10.1192/bja.2019.21] - DOI
Covidence [Computer program]
-
- Covidence. Version accessed 1 April 2024. Melbourne, Australia: Veritas Health Innovation. Available at covidence.org.
Cravero 2006
-
- Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, et al. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics 2006;118(3):1087. [PMID: ] - PubMed
de Vries 2018
-
- Vries K. Primary care: sedating antihistamines: do they still have a role? American Journal of Psychiatry 2018;99(1177):100-3. [ISSN: 0311-8002]
Downes 2009
-
- Downes MA, Healy P, Page CB, Bryant JL, Isbister GK. Structured team approach to the agitated patient in the emergency department. Emergency Medicine Australasia 2009;21(3):196-202. [PMID: ] - PubMed
Erickson 1998
-
- Erickson SJ, Duncan A. Clonidine poisoning - an emerging problem: epidemiology, clinical features, management and preventative strategies. Journal of Paediatric and Child Health 1998;34(3):280-2. [PMID: ] - PubMed
Gonzalez Castro 2017
Gottlieb 2018
-
- Gottlieb M, Long B, Koyfman A. Approach to the agitated emergency department patient. Journal of Emergency Medicine 2018;54(4):447-57. [PMID: ] - PubMed
GRADEpro GDT [Computer program]
-
- GRADEpro GDT. Version accessed 2 March 2021. Hamilton (ON): McMaster University (developed by Evidence Prime). Available at gradepro.org.
Green 1998
-
- Green SM, Rothrock SG, Lynch EL, Ho M, Harris T, Hestdalen R, et al. Intramusuclar ketamine for pediatric sedation in the emergency department: safety profile in 1,022 cases. Annals of Emergency Medicine 1998;31(6):688-97. [PMID: ] - PubMed
Green 2011
-
- Green SM, Roback MG, Kennedy RM, Krauss B. Clinical practice guideline for emergency department ketamine dissociative sedation: 2011 update. Annals of Emergency Medicine 2011;57(5):449-61. [PMID: ] - PubMed
Grunwald 1993
-
- Grunwald Z, Torjman M, Schieren H, Bartkowski RR. The pharmacokinetics of droperidol in anethetized children. Anaesthesia and Analgesia 1993;76(6):1238-42. [PMID: ] - PubMed
Guyatt 2008
Higgins 2019
-
- Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions. Chichester (UK): John Wiley & Sons, 2019.
Higgins 2022
-
- Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Review of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from training.cochrane.org/handbook/archive/v6.3.
Higgins 2022b
-
- Higgins JP, Eldridge S, Li T. Chapter 23: Including variants on randomized trials. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from training.cochrane.org/handbook/archive/v6.3.
Hopper 2015
-
- Hopper AB, Vilke GM, Castillo EM, Campillo A, Davie T, Wilson MP. Ketamine use for acute agitation in the emergency department. Journal of Emergency Medicine 2015;48(6):712-9. [PMID: ] - PubMed
Jackson 2015
-
- Jackson BF, Beck LA, Losek JD. Successful flumazenil reversal of paradoxical reaction to midazolam in a child. Journal of Emergency Medicine 2015;48(3):67-72. [PMID: ] - PubMed
Knott 2006
-
- Knott JC, Taylor DM, Castle DJ. Randomized clinical trial comparing intravenous midazolam and droperidol for sedation of the acutely agitated patient in the emergency department. Annals of Emergency Medicine 2006;47(1):61-7. [PMID: ] - PubMed
Loeffler 1992
-
- Loeffler PM. Oral benzodiazepines and conscious sedation: a review. Journal of Oral and Maxillofacial Surgery 1992;50(9):989-97. [PMID: ] - PubMed
Lovett 2022
Martel 2005
-
- Martel M. Management of acute undifferentiated agitation in the emergency department: a randomized double-blind trial of droperidol, ziprasidone, and midazolam. Academic Emergency Medicine 2005;12(12):1167-72. [PMID: ] - PubMed
Meltzer 1991
-
- Meltzer HY. The mechanism of action of novel antipsychotic drugs. Schizophrenia Bulletin 1991;17(2):263-87. [PMID: ] - PubMed
Miner 2018
-
- Miner JR, Klein LR, Cole JB, Driver BE, Moore JC, Ho JD. The characteristics and prevalence of agitation in an urban county emergency department. Annals of Emergency Medicine 2018;72(4):361-70. [PMID: ] - PubMed
NICE 2015
-
- National Institute for Health and Care Excellence (NICE). Violence and aggression: short-term management in mental health, health and community settings: updated edition. www.nice.org.uk/guidance/ng10 (accessed 1 March 2021). [PMID: ] - PubMed
Oliver 2019
-
- Oliver M, Adonopulos AA, Haber PS, Dinh MM, Green T, Wand T, et al. Impact of acutely behavioural disturbed patients in the emergency department: a prospective observational study. Emergency Medicine Australasia 2019;31(3):387-92. [PMID: ] - PubMed
Page 2020
-
- Page CB, Parker LE, Rashford SJ, Kulawickrama S, Isoradi KZ, Isbister GK. Prospective study of the safety and effectiveness of droperidol in elderly patients for pre-hospital acute behavioural disturbance. Emergency Medicine Australasia 2020;32(5):731-6. [PMID: ] - PubMed
RevMan 2024 [Computer program]
-
- Review Manager (RevMan). Version 7.2.0. The Cochrane Collaboration, 2024. Available at revman.cochrane.org.
Richards 1998
-
- Richards J, Derlet R, Duncan D. Chemical restraint for the agitated patient in the emergency department: lorazepam versus droperidol. Journal of Emergency Medicine 1998;16(4):567-73. [PMID: ] - PubMed
Richmond 2012
-
- Richmond JS, Berlin JS, Fishkind AB, Holloman GH, Zeller SL, Wilson MP, et al. Verbal de-escalation of the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BEYA de-escalation workgroup. Western Journal of Emergency Medicine 2012;13(1):17-25. [PMID: ] - PMC - PubMed
Riddell 2017
-
- Riddell J, Tran A, Bengiamin R, Hendey GW, Armenian P. Ketamine as a first-line treatment for severely agitated emergency department patients. American Journal Emergency Medicine 2017;35(7):1000-4. [PMID: ] - PubMed
Simon 2008
Solmi 2020
-
- Solmi M, Fornaro M, Ostinelli EG, Zangani C, Croatto G, Monaco F, et al. Safety of 80 antidepressants, antipsychotics, anti-attention-deficit/hyperactivity medications and mood stabilizers in children and adolescents with psychiatric disorders: a large scale systematic meta-review of 78 adverse effects. World Psychiatry 2020;19(2):214-32. [PMID: ] - PMC - PubMed
Sterne 2019
Stevenson 2021
-
- Stevenson R, Derek TK. Acute behavioural disturbance: a physical emergency psychiatrists need to understand. B Journal Psychiatry Advances 2021;27(5):333-42. [DOI: 10.1192/bja.2020.67] - DOI
Strayer 2008
-
- Strayer RJ, Nelson LS. Adverse events associated with ketamine for procedural sedation in adults. American Journal Emergency Medicine 2008;26(9):985-1028. [PMID: ] - PubMed
Tampi 2014
Trapani 2000
-
- Trapani G, Altomare C, Liso G, Sanna E, Biggio G. Propofol in anesthesia. Mechanism of action, structure-activity relationships, and drug delivery. Current Medicinal Chemistry 2000;7(2):249-71. [PMID: ] - PubMed
Van Tulder 2003
-
- Van Tulder M, Furlan A, Bombardier C, Bouter L. Updated method guideline for systematic reviews in the Cochrane Collaboration Back Review Group. Spine 2003;28(12):1290-9. [PMID: ] - PubMed
Watson 2020
-
- Watson JC, Whitledge JD, Barbuto AF, Boyle KL, Ganetsky M. Toxicity of agents used for opioid withdrawal: a case-based approach. International Anesthesiology Clinic 2020;58(20):19-27. [PMID: ] - PubMed
Yap 2019
-
- Yap CYL, Taylor D, Kong DCM, Knott JC, Taylor SE, Graundins A, et al. Management of behavioural emergencies: a prospective observational study in Australian emergency departments. Journal Pharmacology Practice and Research 2019;49(4):341-8. [DOI: 10.1002/jppr.1522] - DOI
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical