Haldol, Pneumonia, PD

[Rnfortuna]

Why on earth would any one consider giving Haldol to an elderly patient with Parkinson's disease admitted for Pneumonia???? Just because he/she is confused/agitated!!

[Wile E Coyote, ASN, RN]

Did not know that! Maybe I'm remembering wrong. I know for sure I've given that combo to a couple of psych patients, along with Ativan.

I'll remember that in the future.

Avoiding antihystamines to reduce delirium is particularly important in geriatric population (refer to the current BEERS list for complete list) but they CAN contribute to delirium in any population.

[Been there,done that, ASN, RN]

Why on earth does this make you so upset?

You should ask the provider the rationale. They are usually happy to tell you.

Without more information, I can't answer the question for you.

However, in my experience, if your elderly patient is a danger to himself/herself or to the caregivers, IM Haldol and Benadryl are often given in combination to get them to sleep so that the delirium goes away.

Excessive medication does NOT make the patient's delirium "go away." It makes them pass out.

Snowing the the patient is not the answer.

[elkpark]

I was attempting to include all available interventions regarding the confusion, not the pneumonia.

And I was attempting to offer a general example, not refer specifically to this woman's possible pneumonia.

My point was that the Haldol is not ordered as any kind of restraint; it is ordered as the appropriate, first-line medical treatment for a dangerous, acute medical condition (one with a high rate of mortality when untreated). There is no need or indication to try "other interventions ... first." If you have someone with pneumonia and an antibiotic ordered, do you "try other interventions" before you give the antibiotic? If you have a client with chest pain and nitro ordered, do you "try other interventions" before you administer the nitro? This is the same kind of situation. There is no good reason not to just go ahead and give the medication that is ordered.

[MunoRN, RN]

Excessive medication does NOT make the patient's delirium "go away." It makes them pass out.

Snowing the the patient is not the answer.

There's an important difference between "snowing" the patient and appropriately treating symptoms. Haldol is actually not all that sedating, it sometimes appears that way since alleviation of delirium symptoms will then allow someone who's been in a constant state of panic to finally sleep. This not only relieves the patient's distress but sleep is one of the best way to reduce delirium symptoms.