Name of the Procedure:

Injection, Haloperidol, up to 5 mg (J1630)

Common name(s): Haloperidol Injection
Medical term: Intramuscular injection of haloperidol

Summary

This procedure involves giving an injection of haloperidol, an antipsychotic medication, into a muscle. It's often used to quickly manage symptoms of severe agitation or psychosis in patients who cannot take oral medication.

Purpose

Medical conditions or problems it addresses:

• Acute psychosis
• Schizophrenia
• Severe agitation or delirium

Goals or expected outcomes:

• Rapidly reduce symptoms of agitation or psychosis
• Stabilize patient behavior to allow for further medical assessment and treatment

Indications

Specific symptoms or conditions:

• Severe, acute episodes of psychosis where oral medication is not feasible
• Situations requiring rapid control of symptoms to ensure patient and staff safety

Patient criteria or factors:

• Patients exhibiting severe psychotic symptoms
• Patients with agitation or delirium unresponsive to other interventions

Preparation

Pre-procedure instructions:

• Patients generally do not need extensive preparation.
• Patients or caregivers should inform the healthcare provider of any known allergies to medications.

Required assessments:

• Basic physical and mental health assessment
• Review of current medications to avoid potential interactions

Procedure Description

Step-by-step explanation:

1. Patient positioning: Patient is comfortably seated or lying down.
2. Site selection: The injection site (e.g., gluteus muscle) is identified and cleaned with antiseptic.
3. Injection: A healthcare professional administers up to 5 mg of haloperidol intramuscularly using a sterile syringe.
4. Post-injection: The site is observed for any immediate adverse reactions.

Tools and equipment:

• Sterile syringe and needle
• Antiseptic solution
• Haloperidol solution

Anesthesia or sedation:

• Generally not required; the procedure involves brief discomfort.

Duration

Typically takes a few minutes for the injection itself, with additional time for preparation and patient observation.

Setting

• Hospital emergency room
• Outpatient clinic
• Psychiatric facility

Personnel

• Registered Nurse (RN) or Licensed Practical Nurse (LPN)
• Possibly a physician or a psychiatrist for assessment and prescription

Risks and Complications

Common risks:

• Injection site pain or swelling
• Drowsiness

Rare risks:

• Allergic reaction
• Extrapyramidal symptoms (e.g., muscle spasms, restlessness)
• Neuroleptic malignant syndrome (a severe reaction)

Possible complications management:

• Monitoring for adverse effects
• Administering symptomatic treatments as necessary

Benefits

Expected benefits:

• Rapid stabilization of psychotic symptoms
• Improved patient and caregiver safety
• Reduced agitation allowing for more comprehensive care

Realization time:

• Benefits are typically seen within minutes to an hour after administration.

Recovery

Post-procedure care:

• Monitor the injection site for signs of infection or adverse reactions
• Observe the patient for immediate side effects

Expected recovery time:

• Patient may remain under observation for a few hours

Restrictions and follow-up:

• Avoid driving or operating heavy machinery until the sedative effects wear off
• Schedule follow-up appointments for ongoing care and assessment

Alternatives

• Oral antipsychotic medications
• Intravenous antipsychotic administration
• Non-medicinal interventions such as behavioral therapy (not suitable for acute situations)

Pros and cons of alternatives:

• Oral medications are less invasive but slower acting
• Intravenous administration is quicker but more complex
• Behavioral therapies are useful long-term but not effective for acute control

Patient Experience

During the procedure:

• Brief pain or discomfort at the injection site
• Possible rapid onset of drowsiness

After the procedure:

• Possible sedation or mild disorientation
• Gradual improvement in symptoms of psychosis or agitation

Pain management and comfort measures:

• Local comfort measures such as applying a cold pack to the injection site
• Ensuring a calm and supportive environment during and after the procedure