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Sedation for combative patients

Sarah CAllier sarah_callier at yahoo.com
Fri Aug 8 15:34:55 BST 2008


Versed is the main medication that i am trying to get to carry in our service. We have to present several medications to the Medical director. I think through my research that this would be a good medication but the administrators think ativan is better. The problem with ativan is that it needs to be refrigerated and we do not at this time have our trucks equipped for this. 

--- On Fri, 8/8/08, Jules <jkaymdc at aim.com> wrote:

From: Jules <jkaymdc at aim.com>
Subject: Re: Sedation for combative patients
To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
Date: Friday, August 8, 2008, 7:54 AM

Unfortunately, no, although it is one I'm pushing for. However,
administration and onset of action would still be difficult and fairly long
in this setting. Excited delirium is becoming (or maybe always has been) one
of the biggest scene safety issues for medics, IMO...with the things people
are lacing their recreational drugs with...IS there a chemical restraint
that will be immediately effective? How can it be administered safely...both
for the patient and the medic?

Jules

On Fri, Aug 8, 2008 at 7:32 AM, <msmaltini345 at aol.com> wrote:

> do you carry versed?
>
>
> -----Original Message-----
> From: Jules <jkaymdc at aim.com>
> To: Trauma &amp, Critical Care mailing list
<trauma-list at trauma.org>
> Sent: Thu, 7 Aug 2008 6:24 pm
> Subject: Re: Sedation for combative patients
>
>
>
> i would also be interested in this information. A week ago I was involved
> in
> a call for a "trauma" although the individual had driven the
pick-up into
> the ditch at a slow speed..no damage to the vehicle. However, the person
> was
> showing signs of "meth" use (possible OD), had experienced a
seizure and
> was
> at this time extremely violent, swinging at me and LE each time we
> attempted
> to calm him.
>
> The only medication I had available was Valium...IM of course, which was
> like spitting in the wind.
>
> In the end he was tased 5 times, had received a total of 5 valium IM, 5
> Valium IV, 4 Ativan IV, and 5 Haldol IM (between pre hospital and
hospital)
> before he was controlled.
>
> Suggestions?
>
> Jules
>
> On Thu, Aug 7, 2008 at 4:39 PM, Sarah CAllier <sarah_callier at yahoo.com
> >wrote:
>
>  What is your openion on the sedation of combative patients? I am
>>
> involved
>
>> in a protocal commitie for EMS, We are looking at establishing
>>
> protocals to
>
>> allow the sedation of combative patients. Pt's that would fit into
the
>> catagory for this treatment would be Psychiatric patientswho are
>>
> violent and
>
>> pose a threat to themselves to the Police and to EMS providers. We
>>
> will have
>
>> strict guidelines for the administration of the medications. We are
>>
> looking
>
>> at using Versed Ativan and possibly the use of Droperidol. We are also
>> looking at the possibility of sedation for RSI and for combative
>>
> trauma
>
>> patients. Any openions on what is better?
>>
>>
>>
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