Photo Credit: AndreyPopov
The following is a summary of “Videodistraction to reduce agitation in elderly patients in the emergency department: an open label parallel group randomized controlled trial, ”published in the September 2024 issue of Emergency Medicine by Güvec et al.
In the emergency department (ED), agitation in elderly patients complicates evaluation and treatment.
Researchers conducted a retrospective study to specify if calming video sequences could reduce agitation in elderly patients in the ED.
They screened elderly patients in the ED (≥65 years) for agitation/delirium risk using the 4-A’s test (4-AT). Patients with ≥4 4-AT points were evaluated with the Richmond Agitation-Sedation Scale (RASS) and the Nursing Delirium Screening Scale (Nu-DESC). After informed consent, those with RASS ≥+2 and Nu-DESC ≥4 were included. The intervention group watched calming video sequences for 60 minutes, while the control group received standard care; RASS and Nu-DESC scores were counted after 30 and 60 minutes.
The results showed the intervention group (30 patients) had comparable baseline RASS scores (3 [2–3]) to the control group (27 patients). After 30 minutes of calming video sequences, patients in the intervention group had lower RASS (1 [0–1] vs. 2 [1.5–3], P<0.001) and Nu-DESC (3 [2–4] vs 5 [4–6], P<0.001) scores were compared to control group. This difference persisted for 60 minutes (RASS: 0 [0–1] vs 2 [1–2.5], P < 0.001; Nu-DESC: 2 [2–3] vs 5 [4–6], P<0.001). Additionally, fewer patients in the intervention group (1/30) required additional sedating or antipsychotic medication compared to the control group (9/27) (P=0.004).
They concluded calming video sequences effectively reduced agitation and the need for additional sedatives or antipsychotics in elderly patients in the ED.
