Adult - Excited Delirium Flashcards
Adult - Excited Delirium - Pt over 65 yo?
Treat as per disruptive behaviour protocol
Adult - Excited Delirium - Initial actions
Ensure law enforcement is present
Ensure safety of personnel and patient
Attempt to de escalate the situation
Physical restraint as required
Adult - Excited Delirium - Once physical control is obtained treatment?
Midazolam 10 mg and Haloperidol 5 mg q 15 min to maximums of Midazolam 20 mg and Haloperidol 10 mg
Adult - Excited Delirium - Control achieved next steps? (5)
Obtain BGL Search for medical cause SpO2 ETCO2 1 L NS bolus q PRN
Adult - Excited Delirium - Medical causes for combative behaviour? (6)
Head injury Hypoxia Metabolic Acidosis Infection Seizure Stroke
Adult - Excited Delirium - Treatment priorities in cardiac arrest?
Sodium Bicarbonate 2 mEq/kg
1-2 L NS bolus
Adult - Excited Delirium - Dystonic reaction to Haloperidol?
Diphenhydramine 1 mg/kg IM/IV max of 50 mg or 50 mg PO
Adult - Excited Delirium - Key features of excited delirium?
Hx of drug abuse Hyperthermia Removal of clothing Bizarre behaviour Insensitivity to pain Unexpected strength/endurance Constant movement Shouting
Adult - Excited Delirium - Midazolam indication?
Excited Delirium
Adult - Excited Delirium - Midazolam dose?
10 mg IM q 15 max of 20 mg (mix with haldol)
Adult - Excited Delirium - Midazolam contraindication?
Hypersensitivity to benzodiazepines
Myasthenia gravis
Systolic BP less than 100 mmHg
Adult - Excited Delirium - Midazolam precautions?
May cause respiratory depression and hypotension;
Adult - Excited Delirium - Haloperidol indication?
Excited delirium
Adult - Excited Delirium - Haloperidol dose?
5 mg IM q 15 Max of 10 mg (mix with versed)
Adult - Excited Delirium - Haloperidol contraindication?
Hypersensitivity CNS depression / severe depressive states Spastic disease Parkinson’s syndrome Comatose states Seizure history
