A protocol for the acute control of agitation in palliative care: a preliminary report

Am J Hosp Palliat Care. 2012 Nov;29(7):522-4. doi: 10.1177/1049909111434472. Epub 2012 Feb 23.

Abstract

Agitation is one of the most frequent causes for palliative sedation. It often requires urgent control to avoid negative consequences and even endangerment of all involved, including the patients themselves. A protocol for the control of episodes of agitation was developed, based on a previous experience. The protocol includes a combination of haloperidol and midazolam. The protocol was used 86 times in 27 patients. Each patient was sedated from 1 to 12 times, median 2 times. The median time from the beginning of sedation to the control of agitation was 15 minutes with a range from 1 minute (2 cases) to 3 hours and 5 minutes (only 1 case). In 71 cases (83%), only the first dose was needed. There were no significant complications.

MeSH terms

  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Clinical Protocols
  • Drug Therapy, Combination
  • Haloperidol / administration & dosage
  • Haloperidol / therapeutic use*
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / therapeutic use*
  • Midazolam / administration & dosage
  • Midazolam / therapeutic use*
  • Palliative Care / methods*
  • Psychomotor Agitation / drug therapy*

Substances

  • Antipsychotic Agents
  • Hypnotics and Sedatives
  • Haloperidol
  • Midazolam