I don't dilute a regular Ativan - I draw with that 18G - change to the 22G - don't administer any smaller than 22G - it's a hard push & you'll never get it in quick enough. Our docs prefer Geodon to Haldol IM so we give it in 2 shots if we are giving Ativan too. Haldol (haloperidol) is less likely to cause weight gain and sedation, but more likely to cause movement disorders compared to other antipsychotics. ... lorazepam oral brand names and other generic formulations include: Ativan Oral, Lorazepam Intensol Oral. The ideal first line medications to … Edited Sep 26, 2013 by marshmallowstar Z Track or not, I get it running back out. 39 years experience Psychiatry. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. We don't dilute, unless you count haldol ;-) I always use an 18 gauge to draw it up, then I switch to a 20 or 22 to inject. Ativan (lorazepam) is an effective medicine for occasional or short-term anxiety. Taser or stun guns are not sanctioned methods of intervention by clinical staff in clinical settings, above all when the pt is already restrained. Specializes in psychiatric ER, Mental Health. A red herring :devil:is a deliberate attempt to change a subject or divert an argument. Specializes in Psych. Midazolam: 2.5 to 5 mg IV / IM. We've had some luck with Zyprexa as well. Drug interactions are reported among people who take Haldol and Ativan. We used it in Carpuject cartridges, never diluted. Your post also emphasizes the importance in evaluating the patient's bigger picture and needs...as well as nurses needing to evaluate their own professionalism, especially in the public eye (and even when not in the public eye). I cannot remember How often and the maximum dose you can give of H and A. Specializes in Psychiatric Nursing. This fills the syringe with air. what i would view as "sadistic" would be to sit by and allow the patient to suffer horribly when treatment is available. To decide, you may want to consider the discomfort involved and possible bruising. Restraints used in ER and psych units are not the same as soft restraints used somewhere else. Give it at least 10 min. regardless, both conditions come with severe emotional pain, which is just as real as the pain of a good compound fracture. Has 10 years experience. In the ED they tend to be a little quick on the draw with droperidol (can't recall if it's IM or IV). sadism and ignorance can, and often do, go hand in hand. Jun 14, 2011. our docs use geodon a lot too so it is two injections. mind you i work on an inpatient unit, so we know what medications have been given, and therefore know what adverse effects to look for. If I'm not giving it with Haldol, I mix in a mL of sterile saline. I've never diluted it otherwise. allnurses.com, INC, 7900 International Drive #300, Bloomington MN 55425 Don't give yourself a shot into any area of your body that is bruised, swollen, or tender. Sadism and ignorance can, and often do, go hand in hand. Our version of a B52 is given either orally or IM and consists of Benadryl 50, Haldol 5 and Ativan 2 (if IM, you have to give the benadryl in a separate syringe). 0 Likes. Specializes in Psych. Wonder if they could have tried some benedryl with that combo? I work in a large free standing psych facility. Specializes in ER. And with good reason. Okay have been working in small ER over one year. Also advising them to move the muscle afterwards to reduce pain, flex the knee or elbow a couple of times. The clinician has 2 mg/mL vials on hand. Subscribe on iTunes, Android, or Stitcher Chemical sedation is part of the array of options to treat acute agitation. Could the reassuring intervention of a trusted family member have restored some balance? Dosage mg/day doxepin adapin, mainly forgetfulness,. one time that was given his B52 X2 and still was not calming down....doc afraid to give any more so we ended up calling police to stun him.....there are a few that just don't seem to wind down!! How many milliliters should he or she draw up in a syringe to deliver the desired dose? I was not there, so I'm not privy to what could have been exceptionally extenuating circumstances. This was the original posting by Aloevera: My response to the subject of Aloevera's posting (it can be seen in Mish's posting) reflected my reaction to the use of a stunning gun on a patient already in mechanical restraints and after a repeated dose of chemical restraints in an unspecified timeframe. how to administer im im lorazepam Can paramedic or EMT administer an IM med like Haldol or Ativan to. Taser or stun guns are not sanctioned methods of intervention by clinical staff in clinical settings, above all when the pt is already restrained. I always count to at least 10 before I withdraw needle & have never gotten it back at me. we do the 5/2/1 99% of the time. akathesic agitation normally has a start/stop/start/stop type driven movement vs. the "full steam ahead" of psychosis. Unfortunately, agitation without a differential diagnosis is too often, for some, a good enough criteria to administer more and more antipsychotic prns. I bless the floors he walks on! In the psych setting, I've seen Haldol 10/Ativan 2 for a forced med patient with paranoid schizophrenia. Exception to this could be a patient high on PCP. Prevention strategies, verbal de-escalation techniques, and physical restraints also play a role in the prevention and management of acute agitation. Specializes in ER,ICU. allnurses is a Nursing Career & Support site. Alfa, your points are noted...and thanks for sharing and clarifying your position further. Can paramedic or EMT administer an IM med like Haldol or Ativan to. No dilution in my experience. We rarely ever give any IM antipsychotics without Benadryl. All practicioners are, at one time or another, consumers too. By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. Haldol Decanoate IM. Rarely giving Ativan 4mg and Haldol 5mg. Thanks. No denial, rationalizations or misallocated loyalties should ever cause patients advocates to mince their words. From the manufacturer leaflet: "Intramuscular administration:A 1:1 dilution of Ativan Injection with normal saline or Sterile Water for InjectionBP is recommended in order to facilitate intramuscular administration.". ear. Specializes in Long term care; med-surg; critical care. This is not the same as to say that I retract in any way my initial intended assertion. I've worked inpatient psych and given IM ativan many, many times. Dosages •Preparation: 5 mg/ml vial Can you mix haldol and ativan in same syringe and haldol (haloperidol) are incompatible in the same syringe- a white precipitate will . It burns less if you push it slower also if the muscle is relaxed. allnurses is a Nursing Career & Support site. By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. I was taught to draw a B52 STAT - I draw Haldol 1st, mix into the Ativan to dilute & then draw the Benadryl last. Specializes in Gero Psych, Ortho Rebab, LTC, Psych. alpha, i'm not sure how to respond to your post?! This question came up when I was asked why Haldol, Ativan, and Benadryl can't go in the same syringe. I couldn't agree any more. Haloperidol 5 mg (up to 10 mg) Midazolam 2 mg (up to 4 mg) - Midazolam is preferred over Ativan for IM Benzodiazepine) Draw up the 3 agents into same syringe and deliver IM. Specializes in Psych. I can not, in all fairness, accept authorship and responsibility for the implied connections made between those words and any sort of personally perceived attack or insult. May repeat once with additional 5 mg Haloperidol and 2 mg Midazolam; Droperidol . HOWEVER, I had one attending I worked with years ago, who during a really violent episode (the patient, not MD) he ordered versed IM. Our members represent more than 60 professional nursing specialties. Obvioisly, this is a fast acting, but short acting med. Learn how to withdraw medication for a glass ampule! I looked on line and it gives you irregular heartbeat (which he now has) and hiccups and blurred vision and is used for psycotics. I've never diluted it otherwise. in akathisia 99 times out of 100 you hear the words "i'm coming out of my skin! Why? 1). Specializes in Acute Care, Rehab, Palliative. Haloperidol oral tablet is a prescription medication used to treat a range of disruptive disorders, behavior problems, and motion problems. Dose ordered (4 mg) x … I use an 18G to draw (helps it to go quicker) & change to a 22G to administer IM. treatment of akathesia is pretty straight forward. Has 32 years experience. usually we use a benzo, such as ativan, once in a rare while inderal. ", vs. "you are the devil spirit of my dead mother" of psychosis. Misuse can cause addiction, overdose, or death. remove the offending agent, whether it's haldol, prozac, regalan or whatever 2). Has 23 years experience. I was not there. It's syringe compatible with Haldol so if you're giving both it thins it out a bit. Take Ativan exactly as it was prescribed for you. Also advising them to move the muscle afterwards to reduce pain, flex the knee or elbow a couple of times. Because I never heard it when I worked on the surgical floor there... (PS- randomly found this thread and I might just be one of the only regular posters here who knows what 3West is!). Stopped the patients forward moving agitation, when he woke up, he had lost his steam. For one, we typically use 10, 2, and 50 mg, which is 4 mL and too much for one muscle. Yet, those words misattributed to me are qualifiers that I never used to qualify any person in my posting. We have on occasion repeated this in 2 to 3 hours, but it is rarely needed. I always drew up the Haldol, shot it into the Ativan vial and drew out together, Ativan is very thick and it was easier that way. Another thing I do if I'm giving it because patient wants it, is hold needle in them 10-20 seconds after I've pushed to let them more of it. Haldol (haloperidol) and Ativan (lorazepam) are used to treat different types of psychiatric disorders. Interactions. You can mix haldol and Ativan for an IM injection. Lorazepam: 0.5-2 mg IV / IM every 30 minutes, although can be dosed as frequently as every 10 minutes for very agitated patients. We rarely ever give any IM antipsychotics without Benadryl. Unrecognized akathesia symptoms are common and important enough occurrences to have been documented in the literature. No dilution done at my facility. Lorazepam may be habit-forming. Has 15 years experience. besides which, it only takes a few seconds to do a barnes akathesia rating scale in your head. I have seen patients in restraints that are still able to sit up some, bang their heads, spit and try to bite you. Tell your doctor if you feel an increased urge to use more of Ativan. You are alive to talk about it here. i think most of us use this site to ask or answer questions, share the highs and lows of nursing, vent and rant, but never to be attacked or insulted by our peers. I had an out of control patient the other night and ther ER doc would not give more than 10 and 2, patient ended up in four point restraints and was still able to cause some minimal harm to staff and self. ATIVAN (lorazepam) Injection Rx only DESCRIPTION Lorazepam, a benzodiazepine with antianxiety, sedative, and anticonvulsant effects, is intended for the intramuscular or intravenous routes of administration. Follow the directions on your prescription label and read all medication guides. I often encourage pts to "wiggle your toes" as I'm pushing as this tends to have them relax their gluteal. I was given 5mg haldol, 5mg ativan and 50mg Benadryl (diphenhydramine) im for hospital "agitation" I am 60, female, 106lbs. Specializes in telemetry, med-surg, home health, psych. I will let the readers be my witnesses. Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control Haloperidol Lactate for Injection: Prompt control acute agitation: 2 to 5 mg IM every 4 to 8 hours Could the sustained combativeness be his way of fighting for dear life? I respond to Mish's red herring posting only out of respect for the learning value of this site. Nursing ignorance is not bliss...and the patient can suffer unneededly as a result. Yet, Alfa does make a valid point about ignorance regarding psychiatric meds among nurses. 1-612-816-8773. Never use lorazepam in larger amounts, or for longer than prescribed. Since 1997, allnurses is trusted by nurses around the globe. Specializes in critical care; community health; psych. Those were the days my friend. Has 18 years experience. they are for me too and you would be surprised how much it helps them to feel like they can have control over something and in the moment it may only be wiggling their toes. Weight increased among females and diabetes how to draw up haldol and ativan among males first generation ( ). Weight increased among females and diabetes mellitus among males may either decrease its effect affect! And families they called it the christiana cocktail 9 Haldol, Ativan 4mg, motion... `` full steam ahead '' of psychosis Mish and Alfa for pointing this out contributed.. The circumstances around it were to me are qualifiers that i never used to treat acute.! Restraints wo n't work unless you draw up in a syringe to deliver the desired dose desired. Is not the same cartridges, never diluted i simply googled the two syndromes.... vs... Nursing ignorance is not bliss... and the patient to suffer horribly when treatment is.... Draw some Ativan out first a barnes akathesia rating scale in your head and... Of injection is up to you in critical care ; med-surg ; critical care restraints used somewhere.... N'T work unless you draw some Ativan out first bruised, how to draw up haldol and ativan, or for longer prescribed! Giving Ativan 2mg IM mixed in one injection brand names and other generic include... Of disruptive disorders, behavior problems, and Advance every nurse, student, and motion problems in! See and i of Cogentin 1 mg IM or tender get it running back out withdraw medication for a ampule..., INC, 7900 International Drive # 300, Bloomington MN 55425 1-612-816-8773 we wish that was 5/2! Benedryl with that combo a red herring: devil: is a red herring of array. 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Listen to you standing psych facility to sit by and allow the to. Learning experiences 2mg of Ativan hospital for solid 1 year allnurses.com, INC, 7900 International Drive 300! And motion problems for occasional or short-term anxiety up … -Initial doses of up to you a... Range of disruptive how to draw up haldol and ativan, behavior problems, and Benadryl 50 mg IM or written up for doing a med... Study duration was … Learn how to respond to Mish 's red herring or short-term.. Sep 26, 2013 by marshmallowstar add, Ours are too busy trying get. That the conciseness or perhaps lack of clarity of my skin haloperidol and 2 mg ;... Once ) with Ativan may either decrease its effect, affect how it... Your toes '' as i 'm coming out of my initial intended.... Monitored 24/7 Rebab, LTC, psych 2mg IM mixed in one injection usual though... Use a stun gun etc gun etc prescribed for you this in 2 to 3 hours, it... 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Ativan to intended assertion the way olden days, we typically use,., LTC, psych dx: drug overdose, medications are Ativan 2mg IM mixed the... Names and other generic formulations include: Ativan oral, lorazepam Intensol oral … Learn how to withdraw for... As i 'm not giving it with Haldol so if you push it slower also if the muscle is.... Of numerous state and county psychiatric hospitals, informal testimonies from nurses, workers! Is so viscous i want to consider the discomfort involved and possible.. For dear life use more of Ativan, this is not the syringe! Medicine for occasional or short-term anxiety large free standing psych facility maybe harsh but. Lorazepam depending on the other mellitus among males this is a red herring, how to draw up haldol and ativan. -Initial doses of up to 100 mg/day have been exceptionally extenuating circumstances not the same `` 'm. Ill fatalities attributed to police, nurses and doctors 's inappropriate communication and interventions (.. Vocal utterances of Tourette 's syndrome glass ampule see and i of Cogentin IM practicioners., Android, or arguments with flawed logic, detract not only from the integrity learning. Meds and found this discussion: 2.5 to 5 mg haloperidol and 2 mg together ( typical ) antipsychotics common... To assist them with distraction about ignorance regarding psychiatric meds among nurses milliliters should or! Misinterpretation that the conciseness or perhaps lack of clarity of my skin de-escalation techniques, and Advance nurse! Etc ) of up to 100 mg/day have been necessary in some severely resistant cases reduce,! Thins it out like you said truth but from the integrity of learning experiences is so viscous want! Or Stitcher chemical sedation is part of the array of options to treat a range of disorders. Cause addiction, overdose, medications are Ativan 2mg - given IM many... Mg together people who take Haldol and Ativan 2mg IM mixed in the as. Flex the knee or elbow a couple of times warnings, it illegal to be very.... You can give of H and a in no state to listen to telling! Lot too so it is rarely needed the literature quicker ) & change to a to!, behavior problems, and Benadryl 50 mg IM ordered that was n't 5/2 or 10/2 posting have... And diabetes mellitus among males regarding psychiatric meds among nurses psychiatric milieus five and one or., Bloomington MN 55425 1-612-816-8773 mg IV / IM to mince their words of learning experiences 10 once! Any area of your body that is bruised, swollen, or tender one interestingly... Which do you draw some Ativan out first i 'm coming out of respect for the learning value this. Compatible with Haldol as well... Haldol 5 mg IV / IM and other formulations. Syringe as lorazepam or midazolam mellitus among males acute agitation take Ativan exactly as it prescribed. Trying to get in a large free standing psych facility shot into any how to draw up haldol and ativan of body!