Chemical Restraint?

[fiznat]

I work with both Shane and Code 8 Paramedic, and share that same 5 Haldol, 2 Ativan protocol. I am a new paramedic and have actually only used this combination once so far, but I have seen it done a few times. It is my experience that the drugs dont take much effect until about 10-15 mins after administration which, for us, usually means just about the time we are arriving at the hospital. They are nice to have, I suppose, but I feel the effectiveness of this protocol for seriously combative/dangerous patients is hampered quite a bit by such a long time of onset. Usually the things that really get these patients calmed down (or at least neutralized) are lots of people and physical restraints.

[OVeractiveBrain]

We in New Haven are not fortunate enough to have haldol. Its up to 2mg Ativan or 5mg of Versed IV/IM. Its standing order for patients that are a threat to themselves, online permission required for sedation of combative or violent patients. We can also use at will for anxiety

Man does this stuff work well.

Overactive

[FL_Medic]

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

You are very lucky to have those IM sedatives. I think if I had to put someone down that I didn't have a line on I would want haldol, but I am stuck with intranasal Versed... and it isn't a protocol yet.

[JakeEMTP]

In our little corner of the universe, we have Haldol 5-10 mg IM or Lorazepam 1 mg IM or Midazolam 2mg IM. When I was doing yet another rotation through the ED, 1 of the residents ordered 10mg Haldol IV. Worked wonderfully. Within 30 min, the pt. was sitting up, unrestrained eating lunch, awaiting his admission to the 4th floor.

[Just Plain Ruff]

[Just Plain Ruff]

I find that a suitable 2x4 or oxygen tank works just as well as chemical restraints. JUST KIDDING

[ccmedoc]

I find that a suitable 2x4 or oxygen tank works just as well as chemical restraints. JUST KIDDING

As sad as it is, we have had two patients this year "restrained" with clipboard sedation administered upside the skull.. :? No Joke. Both in self defense with PD present..not good huh? That is why we are trying to improve our sedation protocols, although both situations involved BLS, assaults are becoming more common around here..We have valium 10mg IM, but with med control auth. Too late in most cases by the time the call is made..I appreciate the responses, and look forward to more....

[fiznat]

I'm hoping for a restraint protocol involving Succinylcholine, or perhaps Adenosine drip? Anyone got anything like that?

[OVeractiveBrain]

I hear in Uzbekastan they have intranasal parathion

[OVeractiveBrain]

its an organophosphate