IV Haldol Protocol

A. Optimize medical management

B. Ensure adequate workup: “ICU psychosis” is not a diagnosis

C. Protocol for agitation: goal is calm, awake.
1. Check ECG; if QTc>450, consider alternatives

2. Check Mg (replete to Mg³2); check K (replete to K³4)

3. Haldol 5mg IV x1 (start with 1mg in old or unstable)

4a. If still agitated in 20-30’, recheck ECG;

if QTc>450 or increased by 25%,

consider alternatives or consult cardiology and

use telemetry.

4b. Double haldol dosage; go to 4a.

5. If no longer agitated, give this final dosage as divided

dose over the next 24h.

D. Example:

Haldol 5 -> still agitated @30’ -> Haldol 10 -> still agitated @30’ ->

Haldol 20 -> calm, awake @30’. Then give Haldol 5mg IV q6h x24h