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Trial registered on ANZCTR
Registration number
ACTRN12616000292471
Ethics application status
Approved
Date submitted
16/02/2016
Date registered
7/03/2016
Date last updated
12/05/2022
Date data sharing statement initially provided
20/10/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Procedural Sedation in the Emergency Department: Prospective
Data Collection
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Scientific title
Prospective data collection for procedural sedation performed in the Emergency Department
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Secondary ID [1]
288558
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Procedural sedation in the ED
297671
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Condition category
Condition code
Anaesthesiology
297852
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
3
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Target follow-up type
Months
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Description of intervention(s) / exposure
Procedural sedation in the ED, All procedures involving sedation which occur in the ED during the study period, will be observed by study staff and complications monitored as they occur. Participants will also then be contacted by telephone 1-6 weeks post sedative episode to assess any further complications which occurred following discharge. Patients are observed for the duration of the ED sedative episode, generally 45 minutes or thereabouts, for the recovery period (generally 1 hour), and as well will be followed up by phone between 1 and 6 weeks post discharge from the ED. Patients who are unable to be contacted during this 1-6 week time frame will have phone contact attempts made for up to 3 months. After this point, if still uncontactable, patients willbe deemed lost to follow-up
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Intervention code [1]
293936
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Not applicable
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Comparator / control treatment
No control group, observational study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Major airway complications: Aspiration pneumonitis and/or intubation.
Aspiration pneumonitis assessed clinically by the occurence of cough, wheeze, O2 desaturations (as per pulse oximiter) and new Chest Xray findings consistent with aspiration pneumonitis (Features can be variable and can range from a pulmonary oedema pattern to areas of consolidation or new infiltrates. These changes may have a gravity dependant distribution)
Intubation is assessed by whether the patient is intubated or not.
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Assessment method [1]
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Timepoint [1]
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During ED visit, in sedative period, (usually 45 minutes or so from start point of sedation) and the immediate recovery period (estimated 1 hour post sedation)
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Primary outcome [2]
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Minor airway complications, such as:
Apnoea (cesation in respirations for >20 seconds),
laryngospasm,(acute onset of short lived stridorous inspiratory sounds)
O2 desaturation,(via pulse oximitry)
hypersalivation, (excessive salivation manifest by drooling of saliva)
minor airway interventions performed in ED during sedative episode (Chin lift, jaw thrust, Assisted ventilation) all are clinical actions and will be recorded as occurrring if they are performed
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Assessment method [2]
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Timepoint [2]
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During ED visit, in sedative period, (usually 45 minutes or so from start point of sedation) and the immediate recovery period (estimated 1 hour post sedation)
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Primary outcome [3]
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Other non-airway complications related to the sedation episode, the patient will be observed by the medical officer for complications, these will be recorded on a prospective data collection tool, if complications occurr (as per standard practice during ED sedation or anaesthesia):
vomiting, (noted if it occurrs) as per standard practice during ED sedation or anaesthesia
emergence delirium (combative, excited, or agitated behaviour requiring transient physical or chemical restraint), as per standard practice during ED sedation or anaesthesia
hyper- or hypo-tension, given the wide range of patient ages and deviation of systolic blood pressure by 30% either above baseline (hypertension) or 20% below baseline (hypotension). Blood pressure will be measured using an automated sphygmomanometer as per standard practice during ED sedation or anaesthesia
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Assessment method [3]
297559
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Timepoint [3]
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During ED visit, in sedative period, (usually 45 minutes or so from start point of sedation) and the immediate recovery period (estimated 1 hour post sedation)
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Secondary outcome [1]
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Composite secondary outcome. Post-discharge follow-up for post-discharge effects of sedative medications given in ED. Assessed using a questionnaire designed specifically for this study. Asessed by patient repsonse at telephone interview.
Assessed for:
Vomiting post discharge from the ED
Awareness during sedative episode
Memory of pain occurring during sedative episode
Ongoing pain at IV cannula site
Motor unsteadiness or incoordination post discharge
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Assessment method [1]
320882
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Timepoint [1]
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Patients will be followed up by phone between 1 and 6 weeks post discharge from the ED. Patients who are unable to be contacted during this 1-6 week time frame will have phone contact attempts made for up to 3 months. After this point, if still uncontactable, patients willbe deemed lost to follow-up. Hence the 3 month time limit.
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Secondary outcome [2]
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Procedure related complications, will be based on the procedure performed. If the procedure performed is a fracture reduction, then successful healing of the fracture or review in fracture clinic with no requirement for further intervention would be a secondary outcome. Similarly if sedation was for wound exploration for removal of a deep foreign body, and repair, then outcome would be successful healing of the wound, or wound review that led to no further intervention. Assesed on phone follow-up
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Assessment method [2]
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Timepoint [2]
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Patients will be followed up by phone between 1 and 6 weeks post discharge from the ED. Patients who are unable to be contacted during this 1-6 week time frame will have phone contact attempts made for up to 3 months. After this point, if still uncontactable, patients willbe deemed lost to follow-up
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Eligibility
Key inclusion criteria
patients requiring procedural sedation in ED
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Minimum age
6
Months
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Unable to consent to data collection and follow-up
Unwilling to consent to data collection and follow-up
Senior clinician must be present in the ED to oversee sedation
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
10/03/2015
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Date of last participant enrolment
Anticipated
30/06/2023
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20000
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Accrual to date
2135
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Bundaberg Hospital - Bundaberg
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Recruitment hospital [2]
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Mater Adult Hospital - South Brisbane
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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nill
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Address [1]
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n/a
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Country [1]
292902
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Primary sponsor type
Individual
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Name
Dr Adam Michael
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Address
Emergency Department
Bundaberg Hospital
Bourbong St Bundaberg 4670
Queensland
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Greg Treston
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Address [1]
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Emergency Department
Mater Hospital Brisbane
Stanley St
South Brisbane 4101
Queensland
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Country [1]
291648
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294402
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Gold Coast Hospital and Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Level 2 Pathology and Education Building 1 Hospital Bvld Southport Qld 4215
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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12/02/2013
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Approval date [1]
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25/06/2014
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Ethics approval number [1]
294402
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HREC/14/QGC/40
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Summary
Brief summary
Emergency Department Procedural Sedation is performed many times each day in Emergency Departments around the country. It is becoming an increasingly important skill in the practice of Emergency Medicine. It allows the performance of procedures (including reduction of fractures and dislocations, suturing of wounds, draining of abscesses etc) which in the absence of sedation would be painful and distressing for patients and or technically more difficult or impossible for Doctors. This sedation is increasingly valuable in health systems which demand more efficient use of resources. Effective, safe procedural sedation offers this by saving operating theatres (which are resource intensive) for more complicated procedures. This study aims to add to the current knowledge base by ongoing data collection on procedural sedation done in the Emergency Department. The actual procedural sedation for the patients in the study period will not be influenced by this study. This study will simply document techniques and outcomes of sedation which is done in the normal practice of Emergency Medicine at our Hospital. Complications of the sedation and the procedure will be recorded.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Adam Michael
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Address
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Emergency Department
Bundaberg Hospital
Bourbong St
Bundaberg
4670
Queensland
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Country
63610
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Australia
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Phone
63610
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+61741502220
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Fax
63610
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Email
63610
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[email protected]
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Contact person for public queries
Name
63611
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Adam Michael
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Address
63611
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Emergency Department
Bundaberg Hospital
Bourbong St
Bundaberg
4670
Qld
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Country
63611
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Australia
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Phone
63611
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+61741502220
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Fax
63611
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Email
63611
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[email protected]
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Contact person for scientific queries
Name
63612
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Adam Michael
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Address
63612
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Emergency Department
Bundaberg Hospital
Bourbong St
Bundaberg
4670
Qld
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Country
63612
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Australia
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Phone
63612
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+61741502220
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Fax
63612
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Email
63612
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
13663
Study protocol
Already supplied
370138-(Uploaded-20-05-2020-15-31-47)-Study-related document.docx
13664
Informed consent form
I have uploaded the data collection form. The pati...
[
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]
370138-(Uploaded-27-04-2021-12-18-57)-Study-related document.doc
13665
Ethical approval
Ethical approval was granted via the Gold Coast HR...
[
More Details
]
370138-(Uploaded-27-04-2021-12-23-44)-Study-related document.rtf
13666
Other
2019 Annual report
370138-(Uploaded-08-12-2019-15-12-27)-Study-related document.doc
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF