• Yap Celene Y L CYL 0000-0001-8359-0605 Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria. , David McD Taylor, Kong David C M DCM Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria. , Jonathan C Knott, Simone E Taylor, and Sedation for Acute Agitation in Emergency Department Patients: Targeting Adverse Events (SIESTA) Collaborative Study Group.
• Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria.
• Acad Emerg Med. 2019 Oct 1; 26 (10): 1135-1143.

ObjectiveThe objective was to describe the incidence, nature, and risk factors for adverse events (AEs) among patients who received parenteral sedation for acute agitation in an emergency department (ED) setting.MethodsWe undertook a prospective observational study and a clinical trial of parenteral sedation for the management of acute agitation. We included agitated adult patients who required parenteral sedation from 2014 to 2017 in 12 Australian EDs, excluding those with incomplete information or aged under 18 years. The primary outcome was the number of patients who experienced at least one AE. Multivariable logistic regression was used to determine factors associated with AEs.ResultsA total of 904 patients were included in the analyses (62.3% male; median age = 34 years, range = 18 to 95 years). Of these, 144 (15.9%) patients experienced at least one AE. The most common AEs were oxygen desaturation (7.4%), airway obstruction (3.6%), bradycardia (1.9%), hypotension (1.7%), and prolonged QTc interval (1.3%). No deaths or serious AEs were reported. The following factors had an increased adjusted odds ratio (OR) for experiencing an AE: age 65 years and older (OR = 2.8, 95% confidence interval [CI] = 1.2 to 7.2), more than one type of parenteral sedation administered within 60 minutes (OR = 2.1, 95% CI = 1.4 to 3.1), and alcohol intoxication (OR = 1.8, 95% CI = 1.2 to 2.6).ConclusionsSedation-related AEs are common, especially respiratory events. Elderly patients, sedation with multiple sedatives within 60 minutes, and alcohol intoxication increased the risk.© 2019 by the Society for Academic Emergency Medicine.

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