Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 I hope it is water-soluble before injected. In order to cross the blood-brain barrier, drugs must be lipid soluble. Now back to school for you! Re: Re: Agitated Patients Midazolam is a great IM drug becuase once injected, it becomes water soluble and crosses the blood braine barrier quite quickly. We also have the ability to give it intranasaly. In my service we use Midazolam 5mg and Haldol 5mg IM in a normal adult sized pt. If this doesn't work, then we have the availability to give another 5 + 5 IM. Hopefully this will calm the pt down enough so that we can get an IV, then we can give Ativan 2 - 4 mg IV if needed. The Midazolam 5mg and Haldol 5mg usually works, but you may have to fight the pt for a bit. I have used this combo a couple of times and was able to calm the violent pt enough to get an IV. D. Stone " Alfonso R. Ochoa " wrote: In our chemical restraint standard we are authorized to use 2.5 to 5.0 mg of midazolam. I haven't come across a situation where I had to use it yet, so I'm not sure how midazolam would compare to the other drugs used. Regards, Alfonso R. Ochoa > Haladol is to slow is my only input and the chances you take trying to administer it so the pt starts getting sedated about the time you arrive at a hospital er if you have a long transport greater than > 20 minutes it just isn't worth the needle being poked around there are other drugs that are better and faster. Some one else take it from here. > > ======================================= > Agitated Patients > > > Hey everybody, > > If you could help me out, my medical director posed this question to me: > > > > " I have also been interested in an agitated patient protocol that might use > chemical sedation (specifically haldol or geodon). Could you throw that out > on your discussion group? " > > > > Dr. B, any help is appreciated, also anyone else, all help is appreciated. > > > > Ronnie Morton > > > > > > EMS There When You Need Us > > Ronnie L. Morton > EMS Coordinator Marshall Fire Department > p.o. Box 698 > 303 W. Burleson St > Marshall, Texas 75671 > rmorton@m... tel: > fax: > mobile: > pager: > > > > > > > > Powered by Plaxo Want a signature like this? > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 --- Donnie Stone wrote: > The Midazolam 5mg and Haldol 5mg usually works, but you may have to > fight the pt for a bit. I have used this combo a couple of times and > was able to calm the violent pt enough to get an IV. <HUMOR> Why not just use 100 of sux? </HUMOR> Mike __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 --- Donnie Stone wrote: > The Midazolam 5mg and Haldol 5mg usually works, but you may have to > fight the pt for a bit. I have used this combo a couple of times and > was able to calm the violent pt enough to get an IV. <HUMOR> Why not just use 100 of sux? </HUMOR> Mike __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 --- Donnie Stone wrote: > The Midazolam 5mg and Haldol 5mg usually works, but you may have to > fight the pt for a bit. I have used this combo a couple of times and > was able to calm the violent pt enough to get an IV. <HUMOR> Why not just use 100 of sux? </HUMOR> Mike __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 I apologize, it does becomes lipid soluble after it is injected...my mistake. > > Haladol is to slow is my only input and the chances you take trying > to administer it so the pt starts getting sedated about the time you > arrive at a hospital er if you have a long transport greater than > 20 > minutes it just isn't worth the needle being poked around there are > other drugs that are better and faster. Some one else take it from > here. > > > > ======================================= > > Agitated Patients > > > > > > Hey everybody, > > > > If you could help me out, my medical director posed this question > to me: > > > > > > > > " I have also been interested in an agitated patient protocol that > might use > > chemical sedation (specifically haldol or geodon). Could you > throw that out > > on your discussion group? " > > > > > > > > Dr. B, any help is appreciated, also anyone else, all help is > appreciated. > > > > > > > > Ronnie Morton > > > > > > > > > > > > EMS There When You Need Us > > > > Ronnie L. Morton > > EMS Coordinator Marshall Fire Department > > p.o. Box 698 > > 303 W. Burleson St > > Marshall, Texas 75671 > > rmorton@m... tel: > > fax: > > mobile: > > pager: > > > > > > > > > > > > > > > > Powered by Plaxo Want a signature like this? > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 I apologize, it does becomes lipid soluble after it is injected...my mistake. > > Haladol is to slow is my only input and the chances you take trying > to administer it so the pt starts getting sedated about the time you > arrive at a hospital er if you have a long transport greater than > 20 > minutes it just isn't worth the needle being poked around there are > other drugs that are better and faster. Some one else take it from > here. > > > > ======================================= > > Agitated Patients > > > > > > Hey everybody, > > > > If you could help me out, my medical director posed this question > to me: > > > > > > > > " I have also been interested in an agitated patient protocol that > might use > > chemical sedation (specifically haldol or geodon). Could you > throw that out > > on your discussion group? " > > > > > > > > Dr. B, any help is appreciated, also anyone else, all help is > appreciated. > > > > > > > > Ronnie Morton > > > > > > > > > > > > EMS There When You Need Us > > > > Ronnie L. Morton > > EMS Coordinator Marshall Fire Department > > p.o. Box 698 > > 303 W. Burleson St > > Marshall, Texas 75671 > > rmorton@m... tel: > > fax: > > mobile: > > pager: > > > > > > > > > > > > > > > > Powered by Plaxo Want a signature like this? > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 I apologize, it does becomes lipid soluble after it is injected...my mistake. > > Haladol is to slow is my only input and the chances you take trying > to administer it so the pt starts getting sedated about the time you > arrive at a hospital er if you have a long transport greater than > 20 > minutes it just isn't worth the needle being poked around there are > other drugs that are better and faster. Some one else take it from > here. > > > > ======================================= > > Agitated Patients > > > > > > Hey everybody, > > > > If you could help me out, my medical director posed this question > to me: > > > > > > > > " I have also been interested in an agitated patient protocol that > might use > > chemical sedation (specifically haldol or geodon). Could you > throw that out > > on your discussion group? " > > > > > > > > Dr. B, any help is appreciated, also anyone else, all help is > appreciated. > > > > > > > > Ronnie Morton > > > > > > > > > > > > EMS There When You Need Us > > > > Ronnie L. Morton > > EMS Coordinator Marshall Fire Department > > p.o. Box 698 > > 303 W. Burleson St > > Marshall, Texas 75671 > > rmorton@m... tel: > > fax: > > mobile: > > pager: > > > > > > > > > > > > > > > > Powered by Plaxo Want a signature like this? > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 Come on now, it doesn't relax them that much. We have actually used Versed 10mg and Haldol 10mg, but the ER docs complain because they can't asses the pt when they are that snowed for that long. When you are fighting a combative pt, the 5 + 5 works great. D. Stone P.S. In regards to Sux, we don't carry it because of all of the potential adverse effects. > > > > The Midazolam 5mg and Haldol 5mg usually works, but you may have to > > fight the pt for a bit. I have used this combo a couple of times and > > was able to calm the violent pt enough to get an IV. > > > <HUMOR> > > Why not just use 100 of sux? > > </HUMOR> > > Mike > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 Come on now, it doesn't relax them that much. We have actually used Versed 10mg and Haldol 10mg, but the ER docs complain because they can't asses the pt when they are that snowed for that long. When you are fighting a combative pt, the 5 + 5 works great. D. Stone P.S. In regards to Sux, we don't carry it because of all of the potential adverse effects. > > > > The Midazolam 5mg and Haldol 5mg usually works, but you may have to > > fight the pt for a bit. I have used this combo a couple of times and > > was able to calm the violent pt enough to get an IV. > > > <HUMOR> > > Why not just use 100 of sux? > > </HUMOR> > > Mike > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 Come on now, it doesn't relax them that much. We have actually used Versed 10mg and Haldol 10mg, but the ER docs complain because they can't asses the pt when they are that snowed for that long. When you are fighting a combative pt, the 5 + 5 works great. D. Stone P.S. In regards to Sux, we don't carry it because of all of the potential adverse effects. > > > > The Midazolam 5mg and Haldol 5mg usually works, but you may have to > > fight the pt for a bit. I have used this combo a couple of times and > > was able to calm the violent pt enough to get an IV. > > > <HUMOR> > > Why not just use 100 of sux? > > </HUMOR> > > Mike > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 Cogentin is to block the extrapyramidal effects of the Haldol. Re: Agitated Patients Dr. B., What about Hadol and Cogentin? Anyone out there use those two together for sedation? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 Cogentin is to block the extrapyramidal effects of the Haldol. Re: Agitated Patients Dr. B., What about Hadol and Cogentin? Anyone out there use those two together for sedation? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 Cogentin is to block the extrapyramidal effects of the Haldol. Re: Agitated Patients Dr. B., What about Hadol and Cogentin? Anyone out there use those two together for sedation? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 How well can the ER Docs evaluate a punching, kicking, screaming, biting Patient? I have used my everpresent pocket recorder to illustrate my difficult patients mental state to a couple of ER Docs.....I have never been questioned TWICE by the same Doc. TD > --- Donnie wrote: > > > Come on now, it doesn't relax them that much. We have > > actually used Versed 10mg and Haldol 10mg, but the ER > > docs complain because they can't asses the pt when they > > are that snowed for that long. When you are fighting a > > combative pt, the 5 + 5 works great. > > D. Stone > > > > " These few precepts, keep in thy memory; See to thou character. Give thy thoughts no tongue, Nor any unproportioned thought his act. Be thou familiar, but by no means vulgar. Those friends thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel; But do not dull thy palm with entertainment Of each new-hatch'd, unfledged comrade. Beware of entrance to a quarrel, but being in, Bear't that the opposed may beware of thee. Give every man thy ear, but few thy voice; Take each man's censure, but reserve thy judgment. Costly thy habit as thy purse can buy, But not express'd in fancy; rich, not gaudy; For the apparel oft proclaims the man, Neither a borrower nor a lender be; For loan oft loses both itself and friend, And borrowing dulls the edge of husbandry. This above all: to thine ownself be true, And it must follow, as the night the day, Thou canst not then be false to any man. " Hamlet - Polonious Advice Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 How well can the ER Docs evaluate a punching, kicking, screaming, biting Patient? I have used my everpresent pocket recorder to illustrate my difficult patients mental state to a couple of ER Docs.....I have never been questioned TWICE by the same Doc. TD > --- Donnie wrote: > > > Come on now, it doesn't relax them that much. We have > > actually used Versed 10mg and Haldol 10mg, but the ER > > docs complain because they can't asses the pt when they > > are that snowed for that long. When you are fighting a > > combative pt, the 5 + 5 works great. > > D. Stone > > > > " These few precepts, keep in thy memory; See to thou character. Give thy thoughts no tongue, Nor any unproportioned thought his act. Be thou familiar, but by no means vulgar. Those friends thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel; But do not dull thy palm with entertainment Of each new-hatch'd, unfledged comrade. Beware of entrance to a quarrel, but being in, Bear't that the opposed may beware of thee. Give every man thy ear, but few thy voice; Take each man's censure, but reserve thy judgment. Costly thy habit as thy purse can buy, But not express'd in fancy; rich, not gaudy; For the apparel oft proclaims the man, Neither a borrower nor a lender be; For loan oft loses both itself and friend, And borrowing dulls the edge of husbandry. This above all: to thine ownself be true, And it must follow, as the night the day, Thou canst not then be false to any man. " Hamlet - Polonious Advice Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2004 Report Share Posted August 24, 2004 How well can the ER Docs evaluate a punching, kicking, screaming, biting Patient? I have used my everpresent pocket recorder to illustrate my difficult patients mental state to a couple of ER Docs.....I have never been questioned TWICE by the same Doc. TD > --- Donnie wrote: > > > Come on now, it doesn't relax them that much. We have > > actually used Versed 10mg and Haldol 10mg, but the ER > > docs complain because they can't asses the pt when they > > are that snowed for that long. When you are fighting a > > combative pt, the 5 + 5 works great. > > D. Stone > > > > " These few precepts, keep in thy memory; See to thou character. Give thy thoughts no tongue, Nor any unproportioned thought his act. Be thou familiar, but by no means vulgar. Those friends thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel; But do not dull thy palm with entertainment Of each new-hatch'd, unfledged comrade. Beware of entrance to a quarrel, but being in, Bear't that the opposed may beware of thee. Give every man thy ear, but few thy voice; Take each man's censure, but reserve thy judgment. Costly thy habit as thy purse can buy, But not express'd in fancy; rich, not gaudy; For the apparel oft proclaims the man, Neither a borrower nor a lender be; For loan oft loses both itself and friend, And borrowing dulls the edge of husbandry. This above all: to thine ownself be true, And it must follow, as the night the day, Thou canst not then be false to any man. " Hamlet - Polonious Advice Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 25, 2004 Report Share Posted August 25, 2004 But your pocket recorder lies, And so do the sheep. ========================================= Re: Re: Agitated Patients How well can the ER Docs evaluate a punching, kicking, screaming, biting Patient? I have used my everpresent pocket recorder to illustrate my difficult patients mental state to a couple of ER Docs.....I have never been questioned TWICE by the same Doc. TD > --- Donnie wrote: > > > Come on now, it doesn't relax them that much. We have > > actually used Versed 10mg and Haldol 10mg, but the ER > > docs complain because they can't asses the pt when they > > are that snowed for that long. When you are fighting a > > combative pt, the 5 + 5 works great. > > D. Stone > > > > " These few precepts, keep in thy memory; See to thou character. Give thy thoughts no tongue, Nor any unproportioned thought his act. Be thou familiar, but by no means vulgar. Those friends thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel; But do not dull thy palm with entertainment Of each new-hatch'd, unfledged comrade. Beware of entrance to a quarrel, but being in, Bear't that the opposed may beware of thee. Give every man thy ear, but few thy voice; Take each man's censure, but reserve thy judgment. Costly thy habit as thy purse can buy, But not express'd in fancy; rich, not gaudy; For the apparel oft proclaims the man, Neither a borrower nor a lender be; For loan oft loses both itself and friend, And borrowing dulls the edge of husbandry. This above all: to thine ownself be true, And it must follow, as the night the day, Thou canst not then be false to any man. " Hamlet - Polonious Advice Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 25, 2004 Report Share Posted August 25, 2004 But your pocket recorder lies, And so do the sheep. ========================================= Re: Re: Agitated Patients How well can the ER Docs evaluate a punching, kicking, screaming, biting Patient? I have used my everpresent pocket recorder to illustrate my difficult patients mental state to a couple of ER Docs.....I have never been questioned TWICE by the same Doc. TD > --- Donnie wrote: > > > Come on now, it doesn't relax them that much. We have > > actually used Versed 10mg and Haldol 10mg, but the ER > > docs complain because they can't asses the pt when they > > are that snowed for that long. When you are fighting a > > combative pt, the 5 + 5 works great. > > D. Stone > > > > " These few precepts, keep in thy memory; See to thou character. Give thy thoughts no tongue, Nor any unproportioned thought his act. Be thou familiar, but by no means vulgar. Those friends thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel; But do not dull thy palm with entertainment Of each new-hatch'd, unfledged comrade. Beware of entrance to a quarrel, but being in, Bear't that the opposed may beware of thee. Give every man thy ear, but few thy voice; Take each man's censure, but reserve thy judgment. Costly thy habit as thy purse can buy, But not express'd in fancy; rich, not gaudy; For the apparel oft proclaims the man, Neither a borrower nor a lender be; For loan oft loses both itself and friend, And borrowing dulls the edge of husbandry. This above all: to thine ownself be true, And it must follow, as the night the day, Thou canst not then be false to any man. " Hamlet - Polonious Advice Quote Link to comment Share on other sites More sharing options...
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