Versed IV push or Ativan IVP

MunoRN, RN · Jun 16, 2016

I try really hard not to give either in the ICU, the use of benzos is strongly linked to ICU delirium, versed in particular should be avoided. It is tempting because you do get a period of calm, but then right back to the delirium and potentially making it last longer and be more severe. If the patient is vented we use primarily opiates, sometimes propofol, sometimes precedex, with a dash of benzo here and there if needed. For both vented and non-vented patients with delirium we usually use seroquel for hyperactive delirium, zyprexa for hypoactive delirium, haldol for when those two aren't cutting it, and we've started adding melatonin as well. Benzos certainly aren't completely avoidable, but we do try to minimize them.

TheCommuter, BSN, RN · Jun 16, 2016

Moved to the Critical Care forum for more responses.

PaSSiNGaS, MSN · Jun 18, 2016

offlabel · Jun 18, 2016

don't use either one, especially in the elderly (over 60-65 yo). Bad post discharge cognitive dysfunction. Now that we have precedex, really very few reasons for benzodiazepines. Haldol is better than Benzodiazepines.

guest769224 · Jun 18, 2016

Now that we have precedex, really very few reasons for benzodiazepines.

Precedex is known in my ICU as "expensive water", meaning, it only works half the time. Unreliable.

offlabel · Jun 19, 2016

Then increase the dose or add something other than a benzodiazepine to it if the patient is over 60.

ajb50402 · Jun 20, 2016

Versed is quicker acting, but still don't use it for patients with delirium. Definitely linked to increased ICU delirium and even worse, increased morbidity and mortality. Sleep hygiene, precedex, some pain meds. Try to stay away from the benzos if you can help it

icumurse1122 · Jun 21, 2016

Precedex is known in my ICU as "expensive water", meaning, it only works half the time. Unreliable.

Agree, most hospitals I work for dont even use precedex anymore..

hotcoffee · Jun 22, 2016

It weird how everyone keeps using benzos even when there is evidence they are bad news.

I have even had a hospitalist refuse to order precedex because she didnt want the patient "to get intubated" (??) and order ativan instead.

Lots of better optioms- Precedex, zyprexa, haldol, etc.

propofol and pain meds if intubated.

lighthouse2 · Jun 23, 2016

When using propofol do u use a loading dose?

William2 · Jun 23, 2016

Agree, most hospitals I work for dont even use precedex anymore..

We still use it frequently. I find it a pain in the ass when your maxed on dosage running a new bottle almost every hour.

I'd suggest seroquel, or zyprexa.

Or an ativan drip.