We rarely ever give any IM antipsychotics without Benadryl. besides which, it only takes a few seconds to do a barnes akathesia rating scale in your head. Whenever feasible, exploring and implementing alternative strategies beyond, or preferably before, the most restrictive ones, is what makes a practice holistic. Haldol and Ativan IV? Tomorrow is my first clinical and my very first patient's dx: drug overdose, medications are Ativan 2mg and Haldol 5mg. In the ED they tend to be a little quick on the draw with droperidol (can't recall if it's IM or IV). You can mix haldol and Ativan for an IM injection. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. I can not, in all fairness, accept authorship and responsibility for the implied connections made between those words and any sort of personally perceived attack or insult. Search Recommendations Rationale and Comments: how to administer im im lorazepam Can paramedic or EMT administer an IM med like Haldol or Ativan to. what i would view as "sadistic" would be to sit by and allow the patient to suffer horribly when treatment is available. You can reduce this to “five and one” or increase it depending on the circumstances. I respond to Mish's red herring posting only out of respect for the learning value of this site. It is has been very interesting. This fills the syringe with air. i stopped keeping track of how many times "psychiatric" nurses fail to identify akethisia as a reaction of too much antipsychotics, leading erroneously to a "too much is never enough" mentality when in fact, when it comes to haldol in particular, less is more. Specializes in Vents, Telemetry, Home Care, Home infusion. Never use lorazepam in larger amounts, or for longer than prescribed. May repeat once with additional 5 mg Haloperidol and 2 mg Midazolam; Droperidol . Public opinion trusts professionals to deal with crises professionally. We have on occasion repeated this in 2 to 3 hours, but it is rarely needed. And for two, Benadryl never gets mixed with Haldol in the same syringe: precipitate forms in … Haldol Decanoate IM. A LVN taught me this trick: draw up your Haldol, inject it into the Ativan bottle, then draw the mix back into the syringe. Medicines that interact with Ativan may either decrease its effect, affect how long it … Ativan (lorazepam) is an effective medicine for occasional or short-term anxiety. Thanks! Dose ordered (4 mg) x … I trust that someone with the self described, highly commendable qualities of compassion and a humble opinion atop 30 yrs of experience, can only be on the same, brighter side of the humanistic fence. can you take Haldol 5mg and Lorazepam 2 mg together. in akathisia 99 times out of 100 you hear the words "i'm coming out of my skin! All practicioners are, at one time or another, consumers too. Nursing ignorance is not bliss...and the patient can suffer unneededly as a result. That is an experience I hope to never see and I am sure you felt the same. – use of 20, lorazepam withdrawal warnings, it illegal to be very effective. Has 26 years experience. We have on occasion repeated this in 2 to 3 hours, but it is rarely needed. For example, a provider requests lorazepam 4 Mg IV Push for a patient in severe alcohol withdrawal. I will let the readers be my witnesses. Take Ativan exactly as it was prescribed for you. I am not defending Alfa....but wish to redirect us to the matter at hand on this thread...back to Haldol and Ativan as discussed. Although we attempt to provide accurate and up-to-date information, no guarantee is made to that effect. Plus records of federal investigations of numerous state and county psychiatric hospitals, informal testimonies from nurses, social workers, patients and families. Specializes in Nephrology, Cardiology, ER, ICU. add, Ours are in no state to listen to you telling them to wiggle their toes. Of course in that setting, the patient is monitored 24/7. The posting concluded with the paragraph I think most of us use this site to ask or answer questions, share the highs and lows of nursing, vent and rant, but never to be attacked or insulted by our peers. Lorazepam is in a class of medications called benzodiazepines. No denial, rationalizations or misallocated loyalties should ever cause patients advocates to mince their words. In severe cases of agitation we have used as much as Haldol 10mg, Ativan 4mg, and Benadryl 50 mg IM. Taser or stun guns are not sanctioned methods of intervention by clinical staff in clinical settings, above all when the pt is already restrained. In severe cases of agitation we have used as much as Haldol 10mg, Ativan 4mg, and Benadryl 50 mg IM. A red herring :devil:is a deliberate attempt to change a subject or divert an argument. •Can be mixed in the same syringe as lorazepam or midazolam. Has 15 years experience. Okay have been working in small ER over one year. This question came up when I was asked why Haldol, Ativan, and Benadryl can't go in the same syringe. Our docs prefer Geodon to Haldol IM so we give it in 2 shots if we are giving Ativan too. Specializes in Acute Care, Rehab, Palliative. Specializes in Psychiatric Nursing. My purpose here however is to clarify, not to engage in ad hominem arguments:). Ultimately, the site of injection is up to you. Critical thinking skills as a nurse are required to differentiate between the two syndromes and should guide our assessments...and as a result....when it is appropriate to give that antipsychotic or something totally different. I couldn't agree any more. Only saw it that once, but hey, it worked! With the cap still on, pull back the plunger to the line on your syringe for your dose. Our members represent more than 60 professional nursing specialties. Haloperidol oral tablet is a prescription medication used to treat a range of disruptive disorders, behavior problems, and motion problems. Looking in several different drug reference guides there is no clear and concise answer on if/how this should be done and talking to other nurses that I work with everyone seems to do it their own way. Our concern in over getting fired or written up for doing a forced med! They all corroborate the past and present existence and correlation of ignorance and sadism in too many psychiatric milieus. Your post also emphasizes the importance in evaluating the patient's bigger picture and needs...as well as nurses needing to evaluate their own professionalism, especially in the public eye (and even when not in the public eye). I know it sounds mean, but its easier to draw up and quicker to give rather than having a needle sit in a patient while I have to slowly push it in. Specializes in around 25 years psych, 10 years medical. Unfortunately was unavailable in most regions of U.S., but is once again available as of 2020 Specializes in Psych. Has 5 years experience. sadism and ignorance can, and often do, go hand in hand. mind you i work on an inpatient unit, so we know what medications have been given, and therefore know what adverse effects to look for. Sometimes 5/4 or 10/4 if the patient is built like a linebacker. Dr. Donald Jacobson answered. our docs use geodon a lot too so it is two injections. On the other hand, I don't know either if other more sophisticated considerations would have entered the clinicians' minds. Exception to this could be a patient high on PCP. Working in a psychiatric ward of university hospital for solid 1 year. Actually we are usually giving it with Haldol as well so I guess it does thin it out like you said. This was the original posting by Aloevera: My response to the subject of Aloevera's posting (it can be seen in Mish's posting) reflected my reaction to the use of a stunning gun on a patient already in mechanical restraints and after a repeated dose of chemical restraints in an unspecified timeframe. Has 11 years experience. Usual dose though was 5 of Haldol (never gave 10 at once) with Ativan and either Cogentin or Benadryl. Yet, Alfa does make a valid point about ignorance regarding psychiatric meds among nurses. Thanks. Our members represent more than 60 professional nursing specialties. For one, we typically use 10, 2, and 50 mg, which is 4 mL and too much for one muscle. We called it a B52: Haldol 5mg and ativan 2mg - given IM seemed to calm most folks - lol. We've had some luck with Zyprexa as well. Has 23 years experience. When i worked in wilmington they called it the christiana cocktail 9 haldol, 1ativan and i of cogentin im. Of course, if you're using less than 2mg of Ativan, this won't work unless you draw some Ativan out first. Patients were assigned to groups randomly. Restraints used in ER and psych units are not the same as soft restraints used somewhere else. Since 1997, allnurses is trusted by nurses around the globe. Don't give your Heparin shot within 1 inch (2.54 cm) of a scar or 2 inches (5.08 cm) of your bellybutton. I understand he needs dilaudid, but i'm more afraid of the haldol. one time that was given his B52 X2 and still was not calming down....doc afraid to give any more so we ended up calling police to stun him.....there are a few that just don't seem to wind down!! VCH-PHC Revised June 2009 SYRINGE COMPATIBILITY CHART (Use within 15 minutes) atropine benztropine chlorproMAZINE codeine dimenhyDRINATE diphenhydrAMINE droperidol fentanyl glycopyrrolate haloperidol HYDROmorphone hydrOXYzine lorazepam meperidine methotrimeprazine metoclopramide midazolam morphine proCHLORperazine Dosage mg/day doxepin adapin, mainly forgetfulness,. Another thing I do if I'm giving it because patient wants it, is hold needle in them 10-20 seconds after I've pushed to let them more of it. I was not there, so I'm not privy to what could have been exceptionally extenuating circumstances. I often encourage pts to "wiggle your toes" as I'm pushing as this tends to have them relax their gluteal. Was much more liberal with the meds ordered than the hospital-based one, do... Reduce this to “ five and one ” or increase it depending on the other your. Herring posting only out of 100 you hear the words `` i 'm as... Management of acute agitation sure how to respond to Mish 's posting is a medication. Draw some Ativan out first directions on your prescription label and read medication. Paramedic or EMT administer an IM injection their gluteal detract not only from the integrity of learning experiences similar... Or for longer than prescribed Ortho Rebab, LTC, psych circumstances around it were me. Some luck with Zyprexa as well so i guess it does thin it out a.! Is built like a linebacker guarantee is made to that effect problems, motion... 7900 International Drive # 300, Bloomington MN 55425 1-612-816-8773 to allow for you draw up in a rare inderal... Kill him, this is not the thread, the site you agree to our Privacy,,. Restraints wo n't go in the prevention and management of acute agitation professionals to deal with crises professionally freestanding. On iTunes, Android, or tender posting is a red herring posting only out my! 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