Contributor: Sam Killian, MD

Educational Pearls:

• Agitation can be due to a number of causes, but regardless of the cause, sedation often plays a key role in patient and provider safety. But what is the best sedative agent?
• A study looked at control of agitation with intramuscular medication. Specifically, 5 different IM sedative agents were compared to see which one best provides “adequate” sedation in 15 minutes or less.
• Haldol 5mg, Haldol 10mg, Versed 5mg, Zyprexa 10mg, and Geodon 20mg were all compared, and by far Versed provided the best sedative results. All medications had approximately the same amount of adverse effects.
• There are so many sedative options, but time and time again large dose benzodiazepines have demonstrated great effectiveness in treating acute agitation

References

1) Klein, Lauren R. et al. Intramuscular Midazolam, Olanzapine, Ziprasidone, or Haloperidol for Treating Acute Agitation in the Emergency Department. Annals of Emergency Medicine. 2018. 72(4), 374 – 385

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD