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Lauren R. Klein Brian E. Driver Gabriella Horton Sarah Scharber Marc L. Martel Jon B. Cole 《The Journal of emergency medicine》2019,56(5):484-490
Background
Rapid treatment of agitation in the emergency department (ED) is critical to avoid injury to patients and providers. Treatment with intramuscular antipsychotics is often utilized, but there is a paucity of comparative effectiveness evidence available.Objective
The purpose of this investigation was to compare the effectiveness of droperidol, olanzapine, and haloperidol for treating agitation in the ED.Methods
This was a retrospective observational study of adult patients who received intramuscular medication to treat agitation. Patients were classified based on the initial antipsychotic they received. The primary effectiveness outcome was the rate of additional sedation administered (rescue medication) within 1 h. Secondary outcomes included rescue sedation for the entire encounter and adverse events.Results
There were 15,918 patients included (median age 37 years, 75% male). Rescue rates at 1 h were: 547/4947 for droperidol (11%, 95% confidence interval [CI] 10–12%), 988/8825 olanzapine (11%, 95% CI 10–12%), and 390/2146 for haloperidol (18%, 95% CI 17–20%). Rescue rates for the entire ED encounter were: 832/4947 for droperidol (17%, 95% CI 16–18%), 1665/8825 for olanzapine (19%, 95% CI 18–20%), and 560/2146 for haloperidol (26%, 95% CI 24–28%). Adverse events were uncommon: intubation (49, 0.3%), akathisia (7, 0.04%), dystonia (5, 0.03%), respiratory arrest (1, 0.006%), and torsades de pointes (0), with no significant differences between drugs.Conclusions
Olanzapine and droperidol lead to lower rates of rescue sedation at 1 h and overall, compared with haloperidol. There were no significant differences in major adverse events. 相似文献5.
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Javier Jarazo PhD Kyriaki Barmpa MSc Jennifer Modamio PhD Cláudia Saraiva PhD Sònia Sabaté-Soler MSc Isabel Rosety MSc Anne Griesbeck PhD Florian Skwirblies BSc Gaia Zaffaroni PhD Lisa M. Smits PhD Jihui Su BSc Jonathan Arias-Fuenzalida PhD Jonas Walter PhD Gemma Gomez-Giro PhD Anna S. Monzel PhD Xiaobing Qing PhD Armelle Vitali MSc Gerald Cruciani MSc Ibrahim Boussaad PhD Francesco Brunelli PhD Christian Jäger PhD Aleksandar Rakovic PhD Wen Li PhD Lin Yuan PhD Emanuel Berger PhD Giuseppe Arena PhD Silvia Bolognin PhD Ronny Schmidt PhD Christoph Schröder PhD Paul M.A. Antony PhD Christine Klein MD Rejko Krüger MD Philip Seibler PhD Jens C. Schwamborn PhD 《Movement disorders》2022,37(1):80-94
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Stephanie A. Grilo Marina Catallozzi John S. Santelli Hanying Yan Xiaoyu Song Jennifer Heitel Kristen Kaseeska Julie Gorzkowski Alexandra E. Dereix Jonathan D. Klein 《The Journal of adolescent health》2019,64(3):311-318
Purpose
The objective of the study was to define factors associated with adolescent and young adult (AYA) experiences with private time and having discussed confidentiality and the impact of these experiences on improving delivery of clinical preventive services.Methods
In 2016, a nationally representative sample of 1,918 US AYAs (13- to 26-year-olds) was surveyed. Survey questionnaire domains were based on prior research and Fishers' information-motivation-behavior skills conceptual model. Data were weighted to represent US households with AYA and analyzed to identify factors independently associated with ever experiencing private time and discussions of confidentiality with a regular health-care provider (HCP). We examined the association of these experiences on AYA attitudes about health care.Results
Fifty-five percent of female and 49% of male AYA reported ever having had private time with an HCP and 55% of female and 44% of male AYA had spoken to an HCP about confidentiality. Independent predictors of having experienced private time and confidentiality included older age, race, higher household income, gender of the provider, amount of years with the provider, and involvement in risk behaviors. AYA who had experienced private time and confidentiality discussions had more positive attitudes about their providers, were more willing and comfortable discussing sensitive topics, and thought that these discussions should happen at younger ages.Conclusions
Although confidentiality and private time are important to AYA, many are not experiencing these components of care. Providing private time and discussions of confidentiality can improve the delivery of health care for young people by enhancing positive youth attitudes about preventive care. 相似文献10.
Rebecca K. Papas Benson N. Gakinya Michael M. Mwaniki Hana Lee Alfred K. Keter Steve Martino Debra A. Klein Tao Liu Michelle P. Loxley John E. Sidle Kathryn Schlaudt Tobista Nafula Victor M. Omodi Joyce B. Baliddawa Daniel W. Kinyanjui Stephen A. Maisto 《Addiction (Abingdon, England)》2021,116(2):305-318