From Limited Use to Standard Practice: Retrospective Analysis of Droperidol Administration by Emergency Medical Services (2018–2023)

Objective: This retrospective observational study investigates the usage trends of droperidol (a dopamine receptor antagonist) by Emergency Medical Services (EMS) from 2018 to 2023, focusing on its evolving role in prehospital care. Methods: Using the ESO Solutions, Inc. (ESO) national dataset, we analyzed 56,232,761 EMS cases over six years, examining the rates of droperidol administration by EMS clinicians. We assessed systolic blood pressure (SBP) and heart rate abnormalities after administration, and usage across primary impressions, procedures, and airway interventions. The total database cases grew from 5,536,297 in 2018 to 13,957,073 in 2023, with participating agencies increasing from 1,234 to 3,068. Results: Our findings show an increase in droperidol administration, with doses rising from one in 2018 to 22,372 by 2023. The fraction of doses per million cases increased from 0.18 in 2018 to 1,603 in 2023. Droperidol usage grew from