Protocol for Trauma pt's w/ addiction or mental illness
- 0May 10, '01 by imaRNWhat effective Protocol do you use for Trauma patients that have drug addictions or mental illness? We have trouble when it comes time to
wean or extubate from the vent.on these patients. Any resources or seminars out there? We already use Diprivan,MS,Ativan,or Versed to keep them down during the initial phase.
- 1,533 Views
- 0May 19, '01 by Janet BarclayHi,
A patient who is terribly agitated is probably not ready to wean anyway - they won't protect their airway and won't cooperate with physio etc. We have fairly successfully used propofol to keep folks "down" while they are withdrawing. There is a new antipsychotic... zuclosomething (sorry, the name escapes me)that works fairly well with some people. We've has some success with Haldol 10mg iv q1h until settles or until 80 mg dose given. I know, it sounds like a lot, but sometimes works.
Sedation and analgesia are very unique to the person that you are using them on, I have never seen a protocal that works for every patient.
Have a great day, and yes, I have spent my share of time sitting on patient's chest while they are in DT's
- 0Jun 1, '01 by john williamok... what about diparidol(sp?)diphenidol. I've seen psych. use it on a couple of patients.or just benadryl. cloindine has also been used to treat withdrawls in the past also I believe. If they are actively withdrawing then you will probably still need to treat with librium. or a combination,....a little benadryl , with a little ms, with a little of this and that. how are you weaning. T.piece, c-pap, or positive support ventilation? just going down on the cmv? that can make a bib difference too. again good luck
- 0Jun 1, '01 by imaRNThanks for the input, I think the psych. drugs are what we are missing. These patient's have gone through withdrawl and act psychotic. Some do have closed head injuries and if they "act" ok, would be ready to extubate(and stay extubated).Anyone else have psych. drugs to recommend in the critical care setting?
- 0Nov 28, '01 by PButlerJust about all of our trauma pts have some sort of addiction. we generally stick to the benzos like ativan and wean them slowly. We can usually get them extubated and sent out to the step-down unit where they go into full blown DT's. We also use a lot of Haldol. Any of that class of psych drugs work great and decrease the need for Benzos. Haldol is a great drug...you just need to get that base line EKG first. My personal favorite is Vitamin A!