Paucis Verbis: Chemical sedation for severe agitation

Haldol, Ativan, and Versed… oh my.

In the Emergency Department, some patients present very acutely and aggressively agitated. This is usually the result of illicit drug use or a schizophrenic who hasn’t been taking medications (or both!). Fortunately, we have an arsenal of medications to help sedate the patient.

One study looked to answer the question of what single IM sedation agent is most effective, as measured by the shortest time to sedation and time to arousal.

PV Card: Chemical Sedation for Agitation

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Reference

1. Nobay F, Simon BC, Levitt MA, Dresden GM. A Prospective, Double-blind, Randomized Trial of Midazolam versus Haloperidol versus Lorazepam in the Chemical Restraint of Violent and Severely Agitated Patients. Academic Emergency Medicine. 2004;11(7):744-749. doi: 10.1197/j.aem.2003.06.015

Author information

Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

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