1/🧵 Haldol for ICU patients⁉️
📌 Not so fast
📌 Study of N=1000 backs-up our MIND-USA study - full 🧵👇
📌 Haldol doesn’t treat #delirium
📌 Calms pts & can ⬇️ danger
📌 Delirium care is about non-pharm approaches - the Dr. DRE…
bit.ly/3sz27Pe
📌 Not so fast
📌 Study of N=1000 backs-up our MIND-USA study - full 🧵👇
📌 Haldol doesn’t treat #delirium
📌 Calms pts & can ⬇️ danger
📌 Delirium care is about non-pharm approaches - the Dr. DRE…
bit.ly/3sz27Pe
2/ Dr. DRE = non-pharmacological approaches to #delirium reduction. Hint - it’s Not about adding drugs.
📍Disease remediation
📍Drug Removal
📍Environment (eye glasses, hearing aids, sleep, light, mobilization)
📍Disease remediation
📍Drug Removal
📍Environment (eye glasses, hearing aids, sleep, light, mobilization)
3/ In this thread👇 I unpack our previously published 2018 placebo controlled randomized trial of typical and atypical antipsychotics.
The MIND-USA study & today’s new ACT-ICU RCT are complementary & should make us unsatisfied w ✍🏻 antipsychotics to treat delirium.
The MIND-USA study & today’s new ACT-ICU RCT are complementary & should make us unsatisfied w ✍🏻 antipsychotics to treat delirium.
https://twitter.com/WesElyMD/status/1293288970881703936
4/ This study from 2021 of over a 3500 ICU patients showed longer delirium with Haldol. See below…
https://twitter.com/WesElyMD/status/1361896052324982784?s=20&t=J9Sx7PUrlzeGfOBR-Mq-ew
5/fin
The danger in prescribing haldol for delirium is that we overlook non-pharm treatments like family at bedside, decreasing psychoactive drugs & mobilizing patients.
It does patients a disservice & removes our ability to connect w them on a spiritual & holistic level.
The danger in prescribing haldol for delirium is that we overlook non-pharm treatments like family at bedside, decreasing psychoactive drugs & mobilizing patients.
It does patients a disservice & removes our ability to connect w them on a spiritual & holistic level.
To recap- I use antipsychotics for hyperactive #Delirium when people are dangerous to self or others (way less common thank hypoactive). They are safe & don’t suppress the respiratory drive. That’s the main advantage.
They help you “calm your RASS down!”
@PulmCrit @nickmmark
They help you “calm your RASS down!”
@PulmCrit @nickmmark
• • •
Missing some Tweet in this thread? You can try to
force a refresh
