Haloperidol ... - page 2
by rninme 2,645 Views | 13 Comments
I had an acutely psychotic patient with an order for IV Haloperidol.... I went to the pyxis...selected haloperidol lactate...it dispensed the med. In reading the vial, it stated "FOR IM ADMINISTRATION ONLY". Great...I thought I... Read More
- 0Jun 20, '06 by ZASHAGALKAQuote from barbyannNurses use drugs in 'off-label' ways by order ALL THE TIME.I just put my lawyer cap on and it is all very clear. If the vial states IM only, then you would have a heck of a time convincing the jury you acted in good faith. I have been in many arguements over this drug/route difference of opinion. Stand your ground.
The legal test isn't in the official FDA label but what a prudent nurse would do. Several sources cite that IV haldol lactate is an acceptable choice.
A 'prudent' nurse can indeed use a drug in an 'off-label' fashion. We do it all the time.
But, as has been pointed out, several facilities have policies AGAINST this practice and that policy would take priority in a legal case. If you disobey hospital policy, you probably WILL be liable in a legal suit. So, the first order of business if you are concerned about IV haldol is to check your hospital policy.
- 0Jun 20, '06 by Life_is_good_1973I work in an ICU and we use Haldol IV all the time. It's one of the more frequently ordered drug for severe agitation when ativan/versed, etc. are not effective. Usually the order will read 5mg Haldol IV Q 1 hour. The vials we use say "For IM use only". I've questioned this as well in my unit only to hear "it's always been given". I do monitor my patients for changes in the QT interval and have seen Haldol significantly prolong the QT interval.
Melanie = )
- 0Jun 21, '06 by barbyannThe manufacturer is covering his butt by putting IM only on the vial. The hospital is covering their butt by making policies in regards to Haldol IV. And yet I still see nurses give Haldol IV "cause thats what the MD ordered" "the Pharmacist said it was OK". Protect yourself, always.
I don't think off label use would be a consideration for this route override issue. Therapeutic effect/desired effect is the same just more timely IV. Risk vs. benefit, how much risk are you willing to take?