Conclusion
Overall, droperidol sedates faster and more cleanly than haloperidol or lorazepam, either alone or in combination. Data support not obtaining screening ECGs and continuous cardiovascular monitoring is not required. Droperidol was, in years past, the first-line therapy for sedation; the time has come for it to return to that status.
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ACEP Now: Vol 38 – No 09 – September 2019Dr. Boyer is director of research and academic development at Brigham and Women’s Hospital and associate professor of emergency medicine at Harvard Medical School in Boston.
References
- Perkins J, Ho JD, Vilke GM, et al. American Academy of Emergency Medicine position statement: safety of droperidol use in the emergency department. J Emerg Med. 2015;49(1):91-97.
- Martel M, Sterzinger A, Miner J, et al. Management of acute undifferentiated agitation in the emergency department: a randomized double-blind trial of droperidol, ziprasidone, and midazolam. Acad Emerg Med. 2005;12(12):1167-1172.
- Isbister GK, Calver LA, Page CB, et al. Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: the DORM study. Ann Emerg Med. 2010;56(4):392-401.e1.
- Calver L, Page CB, Downes MA, et al. The safety and effectiveness of droperidol for sedation of acute behavioral disturbance in the emergency department. Ann Emerg Med. 2015;66(3):230-238.e1.
- Richards JR, Derlet RW, Duncan DR. Chemical restraint for the agitated patient in the emergency department: lorazepam versus droperidol. J Emerg Med. 1998;16(4):567-573.
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3 Responses to “Droperidol Is Back (and Here’s What You Need to Know)”
October 19, 2019
Marguerite WrightExcellent article. It would be interesting to follow the use of this drug as it becomes more widely used in the acute clinical setting.
November 21, 2019
Marc Hoffman,MDDr. Boyer,
We are currently trying to get droperidol back on formulary at Mercy Hospital in Portland, for use in the ED. At Brigham, it seems you are not checking the QTc, am I correct? Is there a subset of patients you check the QTc on once they are more sedate?
December 28, 2019
M Bruce Parker MD FACEPI have presented this [& other] articles
to the EDs where I work, to no avail.
Will we wait another 17 years for a new generation of managers to not remember thinking inside this box? When there is no money to be made, progress is slow.