Haldol IV??

  1. Can you give Haldol IV???
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    About dabestrn

    Joined: Mar '03; Posts: 67


  3. by   LilgirlRN
  4. by   Chiaramonte
    IV Haldol Protocol

    A. Optimize medical management

    B. Ensure adequate workup: "ICU psychosis" is not a diagnosis

    C. Protocol for agitation: goal is calm, awake.
    1. Check ECG; if QTc>450, consider alternatives

    2. Check Mg (replete to Mg2); check K (replete to K4)

    3. Haldol 5mg IV x1 (start with 1mg in old or unstable)

    4a. If still agitated in 20-30', recheck ECG;

    if QTc>450 or increased by 25%,

    consider alternatives or consult cardiology and

    use telemetry.

    4b. Double haldol dosage; go to 4a.

    5. If no longer agitated, give this final dosage as divided

    dose over the next 24h.

    D. Example:

    Haldol 5 -> still agitated @30' -> Haldol 10 -> still agitated @30' ->

    Haldol 20 -> calm, awake @30'. Then give Haldol 5mg IV q6h x24h
  5. by   Nurse Ratched
    Originally posted by NightMoonRN
    C. Protocol for agitation: goal is calm, awake.
    Our goal is usually "not beating the snot out of staff."

    I can't tell you the last time we had a patient who needed Haldol who actually HAD an IV site he hadn't torn out. Maybe that's why I've never seen this used as a route lol.
  6. by   traumaRUs
    You can give Haldol IV, but you have to have an EKG prior to giving it - so if they're calm enough to handle an EKG - they probably don't need it. Geodon words better anyway.
  7. by   JMP
    I work in ICU and we use haldol from time to time- however everyone is monitored and ECG's are at our fingertips.

    We LOVE drugs in the unit- ativan, fentanyl, EVERYONE's favouriate, of course if propofol. Haldol would be on the list, but not at the top of the list.

    If you use Haldol, be sure to check the Q-T's as mentioned.
    Last edit by JMP on Mar 24, '03
  8. by   hogan4736
    you can push propofol IV?

    in AZ, nurses have gotten in trouble w/ the board for giving it.

  9. by   RNinICU
    We use propofol IV push for concious sedation, but it must be given by the anesthesiologist. Nursing staff is not permitted to push this med.
  10. by   JMP
    We can, push IV propofol with AN ORDER.

    The pt obviously must be fully vented. However, with very small amounts .... like 10 mg I have pushed it on pts not fully vented- WITH AN ORDER.

    OFten, for short periods, pts are on propofol gtts. IT is recommended that pt not be on for the gtt for more than 48 hours.

    Propofol is high is omega 6 fats and is not recommended for prolonged periods in a pt with sepsis..... since it can contribute to infection.
    Propofol is is a fatty base, hence the white creamy thick liquid.

    This is a common drug where I work.
  11. by   moonshadeau
    That is the first time I have ever heard about getting an EKG prior to administration. Not that it doesn't make sense. I try to stay away from IV/PO Haldol as much as I can, cuz then I have to fill out one of those yucky restraint forms.
  12. by   louloubell1
    I can totally see the point in getting an ECG first as I am aware that haldol can prolong the QT interval, and we did even have a young man code not that long ago because it did just that, but the couple of drug guides that I've looked at do not even mention prolonging of the QT let alone needing to get an ECG first. Isn't that something?
  13. by   GatorRN
    When we have pts in the unit who pull off their leads, then their O2 masks and get hypoxic, pull out IV's, and try to climb out of bed after they have pulled out of their restraints............Haldol IVP is wonderful drug to use!!! I've seen great results. I have learned to love Haldol.
  14. by   Jenny P
    Haldol is a drug that i have a love/hate relationship with. Yes, it does help calm down a confused and agitated patient (and we do give it IV in the ICUs) but when you consider that it is frequently given to the geriatric population, it has a huge half life and I wonder sometimes if we are helping or hurting these patients by using it.

    Moonshadeau, usually in your unit I would guess that your patients already have an ECG before the need arises for them to have the Haldol (you do work in a tele unit, don't you?).

    Trauma RUs, what is Geodon? I haven't heard of that one before.