Drugs for agitated patients?

[krumel]

Used Haloperidol (very rarely), Diazepam (rarely) and midazolam (most of the times) for sedation.

Personally I prefer the Midazolam due to it's ability to give it IN and the fact that it wears of much faster...Which makes it much easier to control, especially if you don't know what else the patient did take....

[AnthonyM83]

Los Angeles can use versed for agitated delirium. It's used pretty rarely, though. It's not meant simply for agitated or violent patients

[Kiwiology]

Los Angeles can use versed for agitated delirium. It's used pretty rarely, though. It's not meant simply for agitated or violent patients

Do you mean the sole use of midazolam is not just for agitation or that it is not a good choice of drug for agitated patients?

[AnthonyM83]

It cannot be used for simple agitation, combativeness, or general chemical restraint. It is only to be used in the case of agitated delirium...which honestly I don't think we're trained thoroughly enough in. It's not just violent. It's not just altered. It's an unexplained delirious episode where the patient is working himself up physically....and at risk of sudden death.

And we also use it seizures.

[Kiwiology]

Are you referring to LA County specifically or midazolam generally?

In LA County nothing surprises me, but if you mean midazolam more generally it is an excellent choice for agitated patients or those in need of a little sedation and/or chemical restraint (what we in NZ use it for)

[AnthonyM83]

LA County specific

[cwilliams17]

Im my area if we suspect behavioral problem or psychotic event, we can give haloperidol 5mg, midazolam 2.5mg, benydryl 25mg. Mostly used in combative patients if we ruled out diabetic or other issue.

Edited March 18, 2012 by cwilliams17

[MedicAsh]

We carry Versed and Valium. While we mainly carry them for seizures. We can administer them for anxiety or agitated patients, but we have to contact medical control prior to get the order. If the patient is too agitated, that is the point we call police. If need be, we have a great working relationship with the law enforcement, we can and will request them to ride with us in the ambulance. I personally have not had to give any medications for agitation.

[Chief1C]

The only time I've ever had issues with patients totally flipping the f*** out, were usually under the influence of something, and on a backboard.. or a combative hypoglycemia patient. Apparently I get pushy in the latter situation, but I've never -knock on wood- required emergency care by EMS. Never had an ALS provider give a patient something to calm down, not once. They get dispatched for every altered mental status call under protocol, but if the patient is (as it would be dispatched a Mental Patient), they may ride in and monitor them. But the only time I've seen drugs used like you're talking about are pediatric seizures, and it every case, it was always diazepam given rectally. I'm usually able to break into the rhealm of the immobilized and "feeling closed in" patients, and talk them into calming down. Though, I have received minor injuries in the process. I have an absolute policy, when I'm done with the stethoscope, even between vitals, I put it in the cabinet. B/c it hurts like a bastard if you get whipped in the face with it.

[P_Instructor]

There flippin' looking at using Ziprasidone (Geodon) here for agitated delirium....I looked the junk up and not so sure with all the contraindications and side effects. I'd rather use a ball peen hammer.