Chemical restraints

[Aznfarmerboi]

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http://www.kget.com/news/local/stor...-plead-not-guilty/4XbSC1oU60KI2RPwmwBfxw.cspx

Seriously. . . I have seen so many Haldol orders PRN that doctors write for nurses. Yet how many nurses are trained to use them? I dont even see protocols for a lot of these hospitals/nursing home. When I was on rotations, I had to educate them that there are actually guidelines. For example, see if the patient is agitated because there is a new change in environment such as new roommates or if they are thirsty/constipated.

 

[Praziquantel86]

Simply "snowing" with haloperidol and lorazepam is a large problem. Unfortunately, it's the only route that a substantial amount of medical interns/residents know how to take. It works quickly and effectively, but there aren't that many more succesful routes to take.

 

[confettiflyer]

Read this earlier, better article here:

http://www.latimes.com/news/la-me-nursing-home-deaths20-2009feb20,0,4381803.story

it was depakote and zyprexa if anyone's curious

 

[Vitamin K]

On our service, we've started taking the prn haldol/ativan off of patient profiles. We may still have it there if the patient has been so aggressive that they're threatening or they're ripping their lines out, but for mild agitation, no way. Nurses tend to err on the side of "let's just sedate them" because it's easier than trying to figure out why the patient is so upset. I'm always worried that they'll hit somebody with the haldol and cover up something major that's really going on.

 

[Requiem]

Gave a presentation on this on Thursday to RN's and "med proficient" LPN's... more specifically the management of BPSD (behavioral and psychological symptoms of dementia)... which certainly involves aggression.

Really gotta push non-pharm here, it's a proactive rather than reactive approach... benzos can cause delirium, worsen cognition, etc., which may present as requiring "more benzos".

Lot of good stuff that's shown basically as effective as antipsychotics... aromatherapy, appropriate speech, pet therapy, orientate with glasses/calenders...

Gotta get people off haldol.