Haldol is an antipsychotic that can be administered intravenously via a controlled drip to treat acute delirium in emergency situations. The drip must be regulated using an IV pump and vital signs are closely monitored every 15 minutes during titration and then hourly. Only haloperidol lactate can be used intravenously and patients require daily ECGs while on the drip due to cardiac risks. Nurses follow standing orders for the usual starting dose of 4mg/hr, titrating up to 15mg/hr maximum based on response measured by the Richmond Agitation-Sedation Scale.

1. Haldol Drips
 Haldol is an antipsychotic agent used to control acute
delirium especially in emergency situations
 Use only with physician order – see Haldol IV Drip standing
orders
 Use the IV pump and go through the drug list and select
Haldol to regulate drip
 Do not mix with other medications
 Protect from light
 Vital signs (B/P, HR, Respirations) are monitored every 15
minutes while titrating drip until stable and then every hour

2. Haldol Drips (continued)
 Spo2 is monitored continuously
 Monitor heart rhythm by telemetry including QT interval and have
telemetry arrhythmia standing orders on chart
 Only Haloperidol lactate can be used IV
 Patient must have a daily ECG while on the drip
 Avoid use in patients with prolonged QT interval
 Watch for increase side effects when given with other drugs that
prolong the QT interval
 Notify physician of any side effects

3. Haldol Drips (continued)
Follow standing orders for use
 Usual starting dose is 4mg/hr
 Do not exceed 15mg/hr without MD approval
 Assess response every 30 minutes using the Richmond-Agitation-
Sedation-Scale (RASS)
 Titrate by 4mg/hr to achieve a satisfactory response
 Once response is achieved, a gradual reduction to the lowest
effective dose is suggested
 Satisfactory response is considered 0 to +1 on the RASS scale

4. Haldol Drips (continued)
Richmond Agitation Sedation Scale (RASS)
 +4 Combative - Overtly combative, violent, immediate danger to
staff
 +3 Very agitated - Pulls or removes tube(s) or catheter(s);
aggressive
 +2 Agitated - Frequent non-purposeful movement, fights ventilator
 +1 Restless - Anxious but movements not aggressive or vigorous
 0 Alert and calm
Rass continued on next slide

5. Haldol Drips (continued)
 -1 Drowsy - Not fully alert, but has sustained awakening (eye-
opening/eye contact) to voice (>10 seconds)
 -2 Light sedation - Briefly awakens with eye contact to voice
(<10 seconds)
 -3 Moderate sedation - Movement or eye opening to voice
(but no eye contact)
 -4 Deep sedation - No response to voice, but movement or
eye opening to physical stimulation
 -5 Unarousable - No response to voice or physical stimulation