Aggressive Patients in ER

1. Mild aggression

    1. Tab risperidone 2mg

        1. or tab lorazepam 2mg

        2. or tab olanzapine 5mg ⇒ do not use with lorazepam (any benzo)

2. Severe aggression but not psychotic

    1. Amp lorazepam 0.5-2mg IV or IM (not available in Iran)

    2. Amp Midazolam 2.5-5mg IV or IM

        1. repeat every 3-5 mins

3. Severe aggression and psychotic

    1. Amp haloperidol 2.5-10mg IV or IM

        1. or Amp dropridol 2.5-5mg IV or IM

4. If drug fails, restrain the pt with 5 man

    1. check pulses and hydration every 15mins

    2. contraindicated in

        1. CVD

        2. Orthopedics

        3. Metabolic disorders

        4. Infections