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Oliver M, Adonopulos AA, Haber PS, Dinh MM, Green T, Wand T, Vitte A, Chalkley D. Impact of acutely behavioural disturbed patients in the emergency department: A prospective observational study. Emerg Med Australas 2018; 31:387-392. [PMID: 30230230 DOI: 10.1111/1742-6723.13173] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The present study describes patients with acute behavioural disturbance presenting to the ED, the impact they have on the department and any complications that occur. METHODS We performed a prospective observational study of adult patients (>17 years old) requiring parenteral sedation for acute behavioural disturbance over a 13 month period. Demographic data, mode of arrival, indication, drug type and dosing used for sedation were collected. Departmental data were recorded including the staff type and numbers involved and the condition of the department. The main outcomes were complications from sedative medication and injury sustained to patients or staff. RESULTS Over the study period 173 patients met inclusion criteria, the majority (n = 104, 60%) were men with a mean age of 38.5 years (standard deviation 14.4); 51% of patients had more than one indication for sedation (n = 89), the commonest being mental health related plus drug intoxication (n = 30, 33.7%). Intoxication was frequently from either alcohol (n = 62, 47%) or methamphetamine (n = 41, 31%). The median number of staff involved was 10 (interquartile range 8-12). Staff members received an injury in 12% (n = 20) of sedations, with only 1% (n = 2) of patients receiving any physical injury; 12% (n = 20) had a minor complication from the sedation medication. No patient had any major complication (apnoea, intubation, arrhythmias or cardiac arrest). CONCLUSION Patients with acute behavioural disturbance often have a history of mental illnesses and are commonly intoxicated. These patients have impacts on healthcare resources and pose risks to staff safety, but significant complications to patients do not occur frequently.
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Affiliation(s)
- Matthew Oliver
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Aaron A Adonopulos
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul S Haber
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Drug Health, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael M Dinh
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Tim Green
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Tim Wand
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexandre Vitte
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Dane Chalkley
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Vautravers G, Brandenberger O, Vitte A, Rossignol F. Articular sagittal and medial parasagittal patellar fracture repair using lag screws in two mature horses. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Vautravers
- Clinique Vétérinaire de Grosbois; Domaine de Grosbois; Boissy Saint Léger France
| | - O. Brandenberger
- Clinique Vétérinaire de Grosbois; Domaine de Grosbois; Boissy Saint Léger France
| | - A. Vitte
- Clinique Vétérinaire de Grosbois; Domaine de Grosbois; Boissy Saint Léger France
| | - F. Rossignol
- Clinique Vétérinaire de Grosbois; Domaine de Grosbois; Boissy Saint Léger France
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Brandenberger O, Rossignol F, Bartke S, Van Bergen T, Vitte A. Carpal arthrodesis using a minimally invasive approach and locking compression plates: Three cases. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- O. Brandenberger
- Clinique Vétérinaire de Grosbois; Boissy St Leger France
- Clinique Equine de l'Ecole Nationale Vétérinaire de Maisons Alfort; Maisons Alfort France
| | - F. Rossignol
- Clinique Equine de l'Ecole Nationale Vétérinaire de Maisons Alfort; Maisons Alfort France
| | - S. Bartke
- Tierärztliche Praxis für Pferde; Warendorf-Milte Germany
| | - T. Van Bergen
- Department of Surgery and Anesthesiology of Domestic Animals; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - A. Vitte
- Clinique Vétérinaire de Grosbois; Boissy St Leger France
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Vitte A, Mespoulhès-Rivière C, Lechartier A, Rossignol F. Removal of cystic calculi using a transinguinal laparoscopic-assisted technique in two stallions. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - C. Mespoulhès-Rivière
- Clinique Equine; École Nationale Vétérinaire d'Alfort; Université Paris-Est; Maisons-Alfort; France
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