Safety and effectiveness of high-dose midazolam for severe behavioural disturbance in an emergency department with suspected psychostimulant-affected patients

File Size Format
52735_1.pdf 128Kb Adobe PDF View
Title Safety and effectiveness of high-dose midazolam for severe behavioural disturbance in an emergency department with suspected psychostimulant-affected patients
Author Spain, David John; Crilly, Julia; Whyte, Ian; Jenner, Linda; Carr, Vaughan; Baker, Amanda
Journal Name Emergency Medicine Australasia
Year Published 2008
Place of publication Australia
Publisher Wiley-Blackwell Publishing Asia
Abstract Objectives: To trial high-dose midazolam sedation protocol for uncooperative patients with suspected psychostimulant-induced behavioural disorders. End-points were effectiveness and safety. Methods: A prospective pilot study was undertaken with a convenience sample of adult, uncooperative patients with suspected psychostimulant-induced severe behavioural disorders. The protocol was midazolam in 10 mg increments, i.m. or i.v., at 10 min intervals, up to four doses and titrated to an end-point of rousable drowsiness. Results: Sixty-two patients were enrolled. Two-thirds of the patients required only one dose of midazolam; 88% of the sample were sedated with two doses. Six and a half per cent of patients were not sedated after four doses. A Glasgow Coma Score of eight or less was prolonged in eight patients. Airway problems requiring an adjunct were present in four patients. Recent psychostimulant use was present in only 55% after full assessment. Conclusions: High-dose midazolam protocols cannot be supported as universally safe. High-dose protocols for severe behavioural disturbance are not more effective, with failures occurring even after repeated dosing.
Peer Reviewed Yes
Published Yes
Publisher URI http://www3.interscience.wiley.com/cgi-bin/home
Alternative URI http://dx.doi.org/10.1111/j.1742-6723.2008.01066.x
Copyright Statement Copyright 2008 Wiley-Blackwell Publishing. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. The definitive version is available at www.interscience.wiley.com
Volume 20
Page from 112
Page to 120
ISSN 1742-6731
Date Accessioned 2009-01-07
Language en_AU
Faculty Griffith Health Faculty
Subject PRE2009-Epidemiology
URI http://hdl.handle.net/10072/26225
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

Show simple item record

Griffith University copyright notice