Clinical Outcomes of Droperidol for Agitation in Trauma Patients in the Emergency Department

Background: Acute agitation in the trauma population complicates emergency care. While droperidol effectively treats agitation in general emergency department populations, literature specific to trauma patients is limited. Objective: This study aims to describe the safety outcomes and clinical success rates of droperidol for acute agitation in trauma patients. Methods: This retrospective, observational cohort study at a Southeastern, U.S. Level I trauma center included adults who presented as a trauma activation and received droperidol in the emergency department between February 1, 2020 and August 31, 2024. Patients were excluded if the droperidol dose was <2.5 mg or received antiemetics or sedatives prior to droperidol. The primary outcome was the need for rescue sedation within 60 minutes of droperidol administration. Secondary outcomes included intubation, hypoxia, and hypotension. Results: There were 66 patients included. Patients were primarily white males with a median age of 44 years. Majority of patients received droperidol 2.5 mg ( n = 48, 73%) intravenously ( n = 60, 91%). Twenty-six (39.4%) patients required rescue sedation within 60 minutes of droperidol administration, 16 of which required additional droperidol. These patients were younger and had a shorter time to initial droperidol administration. Fourteen (21%) patients had a new oxygen requirement, two of which were intubated. One patient experienced hypotension not attributed to hypovolemia. Conclusion: This study provides descriptive data suggesting droperidol may be useful for agitation in trauma patients with few serious adverse events. However, prospective randomized controlled studies are required before routine use can be recommended over other agents.