see also Sedation Protocol
Several options are available for sedation including neuroleptics (eg Haloperidol), Non-Neuroleptic Antipsychotics (eg Olanzapine, Risperidone) and Benzodiazepines (eg Clonazepam, Midazolam, Lorazepam).
The choice of drug is influenced by the clinical scenario (see Chart of Sedatives and Antipsychotics)
Benzodiazepines are universally given in agitated patients with the addition of antipsychotics and neuroleptics when an acute psychosis or perceptual abnormalities are present.
N.B. in alcohol withdrawal, diazepam is the agent of first choice
N.B. sedation with either midazolam or propofol should not occur without intubation, controlled ventilation and CT head in head injured patients
see Restraint in patient subgroups
(can be repeated @ 30 min)
(can be repeated @ 5-10min)
Benztropine 1-2mg IV/IM should be used in the event of dystonic reactions to haloperidol.
Ensure O2 saturation monitoring and close observations of vital signs.
Following drug administration, the patient must be "specialled" if their GCS is 8 or less. This is to be undertaken by nursing staff member. Vital signs/obs to be completed 15 minutely. Assist with airway protection in the event of vomiting.
Where a mental health patient requires restraining, a detention order must be completed.