Recruitment to the prospective study was assisted by in-servicing which helped to ensured that all of the patients who required the site parenteral sedation and mechanical restraint were recruited to the study due to staff awareness and only six were missed (Figure ​(Figure11). Main Outcomes The

primary outcome was the duration in minutes of the ABD comparing patients during the new intervention to the historical controls. Other outcomes included the requirement for additional sedation and adverse effects from the sedative medication, which includes both patient and staff incidents. Additional sedation included Inhibitors,research,lifescience,medical further sedation required to obtain initial sedation as well as re-sedation if the patient re-emerged Inhibitors,research,lifescience,medical still agitated. Re-sedation was defined as sedation after an interval exceeding one hour where no further sedation was given during that time, based on repeat sedation in a previous study[2]. Sedative related adverse effects included any

episodes of oxygen desaturation (< 90%), hypoventilation (respiratory rate < 12), requirement for airway intervention or support, arrhythmias or hypotension. Staff or patient injuries were also determined for both groups and were reported during both periods as per hospital guidelines for incident Inhibitors,research,lifescience,medical monitoring. Data Analysis Medians and interquartile ranges (IQR) are reported for all continuous variables. Percentages are reported for dichotomous outcomes with 95% confidence intervals (CI). Comparison of continuous variables between the two groups was performed using the non-parametric Mann-Whitney test. Statistical analysis was performed using Prism 5.01 (GraphPad Software Inc). Results There were 58 patients recruited Inhibitors,research,lifescience,medical during 8 month period where the new IM sedation protocol was used. These were compared to 73 historical control patients Inhibitors,research,lifescience,medical that similarly required parenteral sedation in the 8 month period prior to the

new IM protocol. Only 20 of the 73 historical controls (27%) initially received IM sedation, compared to all patients for the IM sedation protocol. Baseline characteristics for both groups are compared in Table ​Table11 and are similar except for the selleck larger proportion of males during the new protocol. Cilengitide Table 1 Baseline characteristics of the historical control patients compared to patients with the new protocol of intramuscular sedation The median duration of the ABD in patients with the new sedation protocol was 21 minutes (IQR: 15 to 35 minutes; Range: 5 to 78 minutes) compared to a median duration of 30 minutes (IQR: 15 to 50 minutes; Range: 5 to 135 minutes) in the historical controls which was significantly different (p = 0.03) [Figure ​[Figure22]. Figure 2 Box and whisker plots showing the duration of the ABD comparing historical control patients to patients with the new sedation protocol. The whiskers are the 5th and 95th percentiles, the box the interquartile range, extreme outliers are filled circles ..