Page 1 of 1: Reaction to Haldol

junejo · Credits: 3915 My Scrapbook

21 year old with stiff neck -Take a relevant hx -dyskinetic reaction to Haldol

Any comments

Kai1111 · Credits: 2036 My Scrapbook

Introduce, wash hands and start with open ended question? His jaw will be so rigid, he probably won't beable to tell you much....clearly uncomfortable. Then....

Focused questions:
Onset and chronology.
Location of stiffness
exacerbating/alleviating sxs
Prior hx
Jaw stiffness
Trouble ambulating
any spasmodic movements/trouble walking
any grimacing
back arching
torticollis
SOB
CP
How long have you been on Haldol
Last dose
Any other h/o dsytonic reactions

PE: Vitals/02sat
ENT exam...tongue, neck, jaw.
r/o significant laryngospasm...if present prepare to attempted intubation and/or cric...hopefully an ENT doc is in house?
Chest/CV exam
Neuro - intact?

Explain to the patient that his symptoms are likely due to a side effect of Haldol...it is fairly rare, but seen from time to time...fortunately we have medication that will make him better over the next few hours. If his airway becomes compromised, however, he will require intubation and/or surgical intervention.

TX: benztropine 1-2mg IM then 2mg po qdX3days,...or

I usually give dimenhyrinate 50mig IM or IV initially, then PO for 3 days. I will also give ativan or valium for anxiety, if necessary.

junejo · Credits: 3915 My Scrapbook

Thank you Kai1111.

It was very informative.

I appreciate it

bush5 · Credits: 1122 My Scrapbook

if patient is coming with neck stiffness

enquire about fever, numbness, weakness, trauma to neck

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