[aila]

I am working in small rural hospital that has two new internists. They refuse to use midazolam or lorazepam for sedation and prefer using haloperidol (Haldol). Last week they attempted to intubate with haloperidol rather than the other two. Has anyone any data on use of Haldol for sedation and why they would rather use it?

[mustangsheba]

I don't understand MD's love affair with Haldol. It certainly seems inappropriate to use for intubation.

[susanmary]

Originally posted by aila:
I am working in small rural hospital that has two new internists. They refuse to use midazolam or lorazepam for sedation and prefer using haloperidol (Haldol). Last week they attempted to intubate with haloperidol rather than the other two. Has anyone any data on use of Haldol for sedation and why they would rather use it?

I have never heard of using Haldol for conscious sedation, and would be interested in the new doctor's rationales for doing so. You really should ask them. Also, your hospital should have written policies & procedures regarding conscious sedation, including medication administration (is Haldol listed as a medication to be used for conscious sedation?) Another resource would be your hospital pharmacist. The other posts are on-the-money regarding the extra-pyramidal side effects (from even a 1x dose) from Haldol. Keep us updated on what you find out.

[Cameron Johnston]

I worked in hospital & psychiatry for seven
years and our number one drugs for use in
sedation was Ativan (lorazapam).
I am also surprised that they would
use haloperidol for sedation for intubation!
Although it's classified as a sedative, it
is also classified as a hypnotic and even
in psychiatry it is used less often today
due to newer, less-harmful antispychotics
(although most still can cause extra-pyrami-
dal sx). In my experiences, haldol can cause these extrapyramidal sx. (sometimes
for life), benzodiazapines such as lorazapam
and the others you mentioned don't. Also,
I have seen benzo's to be much more sedating
than haldol. This is why it is so perplexing that one would use it for what
you describe. Of course, I'm not an M.D.
and they may have some cryptic reason that
is not recognized in mainstream? Probably
the use of Haldol one-time would signifi-
cantly reduce the chances of EPS, but man
that is wierd. I am the type that would
politely and uninsultingly inquire with the
docs to see why they prefer it. Please let
us know...

[justanurse]

Be very careful. Check out your policy.

At the hospital I work, we had a state review last summer. A nurse received an order to give Haldol to a patient who was very uncooperative & combative in an attempt to sedate the patient. The nurse did not chart any s/s of psychotic behavior and we had to defend why the anti-psychotic medication was ordered/given & not a sedative. Yes, the nurse should have charted a little better, but hind-sight is 20/20.

Haldol is an anti-psychotic.

At our facility we use Versed for sedation, along with a little MS or Demerol for pain control. Both of these are reversable quickly if needed.

Good luck!

[aila]

Thanks to all of your for your replies and concerns. I am currently wading thru policies and procedures and trying to update them along with being a full time night ICU nurse.

Good ammunition is the one about haloperidol being an anti-psychotic, not a sedative. I am just now trying to teach the nurses how to do Swan line set ups and getting the P&P changed to let IV bags hang more than 24 hours.

Haha, most of my job is an uphill battle, but the perks of knowing most everyone and being close to my daughter... well they count the most.

[willie2001]

I also work in a small rural hospital. We have internists and 4 CRNAs. I have never seen any of them us Haldol for sedation prior to intubation. We ordinarily us
Versed for that purpose. We use IV haldol for postoperative psychosis sometimes.

[aila]

Originally posted by willie2001:
I also work in a small rural hospital. We have internists and 4 CRNAs. I have never seen any of them us Haldol for sedation prior to intubation. We ordinarily us
Versed for that purpose. We use IV haldol for postoperative psychosis sometimes.

Thanks again, everyone for your posts. An update....I got propofol (Diprivan) approved for conscious sedation and vent sedation. Everyone is pleased with the results.