Chemical Restraint?

[ccmedoc]

I was wondering how many have protocols allowing sedation as a restraint or as an adjunct to soft restraints in the event of combative patients. What they are (the meds), and maybe some thoughts from the gurus on the appropriateness and safety of using chemical restraint.

If this has been asked before, I apologize

[kevkei]

We use Ativan or Versed (Midazolam). Preference is the Versed as absorption is faster, generally the dosing we use is 5-10 mg deep IM, or if you have access, 2.5-5 mg IV. Ativan is 2mg deep IM or 1-2 mg IV.

[JPINFV]

Paramedics can use Midazolam 0.1mg/kg IVP for a max of 10mg or 10 mg IM with a base hospital order.

[medic001918]

We have 5mg Haldol & 2mg Ativan IM for combative patients on standing order. I think that chemical restraint definately has a place in prehospital care since safety is always a priority. Once someone is sedated, it should become safer to transport them in the back of an ambulance in an enclosed space. I don't use the protocol frequently, but when I do need it I'm glad to have it and more importantly to not have to call to do it.

Shane

NREMT-P

[ccmedoc]

We have 5mg Haldol & 2mg Ativan IM for combative patients on standing order

Ahhhhh.....the better part of the B52.. A lot closer to my comfort zone....Do you know how long this protocol has been implemented??

Any training about Excited Delerium or Cocaine Induced Delerium included?? VERY curious :-k

[Code 8 Paramedic]

I work with Shane, and that protocol has been around for a while at least a few years

[itku2er]

Ativan 1-2 mg IV or IM

[kevkei]

Any training about Excited Delerium or Cocaine Induced Delerium included?? VERY curious :-k

Yes and these patients scare the crap out of me. We have had a few in custody deaths recently here associated with this and subsequent police intervention. Sad part is it is significantly misunderstood and neglected.

[Scaramedic]

Poop!! I thought this thread was someone looking for a date.

Damn!!

Peace,

Marty

[john51071]

For quite a few years, we used Versed. IM 5-10mg, or IV 2-5mg. It worked very well and very rapidly. The one case of ED we had, it didn't seem to do much at all.

At the service I currently work for we use Haldol IM, up to 5mg. I have had only one opportunity to use it, but it doesn't seem to obtund patients as much as the Versed did, but still calmed them enough to assess, treat and transport.