Combative, awake & staying that way

Specialties Emergency

Published

Specializes in Emergency.

So anyway, 40ish developmentally disabled male comes in the other day, s/p fist to face with 3cm lower inner lip lac. This pt is known to us and uncooperative under the best of circumstances.

To make a long story short, in order to mellow him to the point he could be sutured, I wound up giving the following, but not all at once, really titrating to unconscious:

Haldol 10mg im

Ativan 6mg im

Versed 12.5mg ivp

Fentanyl 50mcg ivp

Slept for 2 hours, woke up swinging, d/c to group home.

The fun never ends.....

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Specializes in ICU.

Wow! But how did you get an IV into him in the first place?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

That's what I was going to ask........I was going to say "So you gave ketamine IM?"

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Specializes in Emergency.

After the 10 & 6, he chilled just enough to go dog pile on the rabbit & get a line in him.

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Specializes in med-surg, psych, ER, school nurse-CRNP.
After the 10 & 6, he chilled just enough to go dog pile on the rabbit & get a line in him.

OK, THAT one, even I've never heard...and my claim to fame here is my ability to turn a (redneck) phrase. That's hilarious!

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Yeah, I had 60 year old with dementia and ptsd last week like that. Nursing home gave him 6 mg Ativan, 20 mg Geodon. Came in fighting and had to put leathers on him. Gave him another 4 of Ativan, 15 mg Haldol, 2.5 mg Inapsine. Dude would not go down.

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Specializes in Emergency.

It's from Bugs Bunny, whom I quote on a regular basis..... Here the clip for your entertainment:

Dogpile on the Rabbit! - Looney Tunes/Bugs Bunny - YouTube

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Specializes in Emergency, Haematology/Oncology.

Aaaaah yes, those who don't respond to sleepy stuff. Twice now in my time in the asylum that is Emergency, unsuccessful titrated administration over about 15 minutes of the following:

30 mg IV Diazepam

30 mg IV Haloperidol

40 mg IV Midazolam

Still requiring 6 security guards to hold him down (assaulted two nurses already), chasing our tails. Physician gives 40 of Propofol, he went to sleep after that. I should mention that the white stuff only comes out on special occasions.

Starting to use droperidol IM for neurolepts, working well.

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Specializes in ER, ICU.
Yeah, I had 60 year old with dementia and ptsd last week like that. Nursing home gave him 6 mg Ativan, 20 mg Geodon. Came in fighting and had to put leathers on him. Gave him another 4 of Ativan, 15 mg Haldol, 2.5 mg Inapsine. Dude would not go down.
What is it with elderly dementia patients and superhuman strength?! The must shocked I've ever been was with a 90yr old who almost broke my finger bending it backwards as I was holding her hand during an i&o cath!!
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