Point-Counterpoint | IV Haloperidol Should be Avoided in the Emergency Department
Spoon Feed
Here are the counterpoints for why these authors think intravenous (IV) haloperidol (Haldol) should be avoided in the emergency department setting.
Spoon Feed
Here are the counterpoints for why these authors think intravenous (IV) haloperidol (Haldol) should be avoided in the emergency department setting.
Spoon Feed
The next couple of reviews will look at different authors making their case for why intravenous (IV) haloperidol (Haldol) should or should not be used in the emergency department setting.
Source
Haloperidol May Be Safely Administered Intravenously in the Emergency Department. Annals of Emergency Medicine. 2023;81:95-96. doi: 10.1016/j.annemergmed.2022.07.004
Spoon Feed
Hospital adoption of phenobarbital for severe alcohol withdrawal syndrome (SAWS) was associated with lower rates of invasive mechanical ventilation (IMV).
Source
Phenobarbital for Severe Alcohol Withdrawal Syndrome: A Multicenter Retrospective Cohort Study. Am J Respir Crit Care Med. 2022 Nov 1;206(9):1171-1174. doi: 10.1164/rccm.202203-0466LE.
Spoon Feed
Inconsistency and incongruence are two keys to diagnosing a functional neurological disorder. The video demonstration really helps sort this out.
Source
Inconsistency and incongruence: the two diagnostic pillars of functional movement disorder. Lancet. 2022 Jul 23;400(10348):328. doi: 10.1016/S0140-6736(22)01184-9.
Spoon Feed
Patients with long COVID had a host of symptoms, poorer quality of life, and more anxiety and depression, but they did not have a specific cause identified for symptoms despite a comprehensive exam and battery of tests.
Source
A Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings. Ann Intern Med. 2022 Jul;175(7):969-979. doi: 10.7326/M21-4905. Epub 2022 May 24.
Spoon Feed
This systematic review suggests that droperidol is both safe and effective for treating agitation in the pediatric population.
Source
A Systematic Review of the Effectiveness and Safety of Droperidol for Pediatric Agitation in Acute Care Settings. Acad Emerg Med. 2022 May 1. doi: 10.1111/acem.14515. Online ahead of print.
Spoon Feed
New research on droperidol shows that it is a safe and effective medication for a multitude of common ED presentations, despite an FDA black box warning for QTc prolongation in 2001.
Spoon Feed
The quick answer is yes. This has been a debate in the critical care and pain literature for quite some time, but according to this trial, we finally have our answer – receiving opioids in the ICU increases the odds of delirium in a dose-dependent fashion
Spoon Feed
Use of intramuscular ketamine for patients with severe agitation resulted in significantly shorter time to sedation compared to a combination of intramuscular midazolam and haloperidol (5.8 vs 14.7 minutes).
Spoon Feed
There was no difference between IM droperidol and IM olanzapine in time to adequate sedation for the acutely agitated ED patient. Droperidol carried a slightly higher risk of extrapyramidal effects.