Demetri Tavoulareas, MD
1) For acute agitation/violence: Haldol 5mg Ativan 2mg IM combo is fast, effective, and well-tolerated. For the elderly consider half-dosing. For functional agitation (known psyc d/o), Geodon 20mg IM is becoming the go-to choice for psychiatrists.
2) Know your demographics and risk factors for suicidal patients. Bedside assessment scales are predictive of need for hospitalization, NOT for risk of future self-harm so err on the side of caution
3) Routine medical screening with Chem8, UDS, Etoh is neither cost-effective nor necessary. Decision-making for testing should be based on history, physical, meds, comorbidities, and clinical presentation.