Worth remembering this episode aired in 2004, so while I have no clue what drugs were and weren't commonly administered back then, it wouldn't be a surprise if many of them were no longer regularly prescribed 16 years later. "Heck, if you've been out of med school five years, half of what you learned is obsolete." - Dr. Kelso
@@DoctorElliottCarthy Yes, Ativan is lorazepam. Midazolam usually worked well; however I've given 10 mg, in 2 doses, to someone high on crack and meth with no effect.
@@DoctorElliottCarthy In our ED, at least when it comes to violently psychotic patients, we use the very nicely named B52 shot, which is 50mg of Benadryl (Diphenhydramine), 5mg of Haldol, and 2mg of Lorazepam. That will usually sedate them enough for us to hook up an IV and actually get something going before we can transfer them to med surg while we try to find psych placement.
@@DoctorElliottCarthy I wish the U.S only used the generic names, would make life a lot easier. Standing around in rotations with a blank face because I didn't know that Zosyn was Piperacillin/Tazobactam.
New to the channel. Loving it so far. I recommend watching the episode "My five stages" where JD and Dr. Cox deal with the terminal diagnosis of a long term patient at the hospital.
For the not Italian guy I’d assume it’s referencing foreign accent syndrome. It tends to come up as a quick joke in a lot of medical shows like this, but I’m not an expert and I’ve only really heard of it in passing tbh.
Actually was just gonna write this myself. I learned about it in school that there are documented cases of it resulting after a patient has suffered a TBI or Stroke.
I'm certainly guilty of stopping my psyche meds... Though I did have a good reason, I used to have chlonidine to treat motor tourrettes, but the specific brand I took was discontinued the year I started taking it and the supply dried up. I was put on a more generic version of the drug... And after a couple days of throwing up blood, I stopped taking it. It's worth adding to this my prescriptions are generally incredibly high dosage in general as I have an abnormally strong resistance to drugs and toxins. So if there is a particularly bad side effect, it's more likely to occur... I also have hypersensitive touch and feel pain at a magnitude of roughly x3-x9 so that wasn't fun at all (cause yeah... No amount legal of morphine is numbing that)
Speaking of haloperidol and weird side effects, i took one by accident once. The guy who gave it to me said it was klonopin ( a xanax like benzo) and when that pill kicked in my body was locking up BAD, first it was my jaw, it locked so bad i broke a tooth, then i started having trouble walking, and not like im dizzy, but more like certain muscles just werent working, I imagine it was a very odd sight, last thing ill mention is it made my abs cramp so bad i was screaming in pain, and wound up in the hospital.
Not-so-fun-fact: Terry Jones of Monty Python had frontotemporal dementia for some years before his passing. I'm not sure particularly how it affected him, but from my understanding, he lost most of his ability to speak, not because he physically couldn't, but rather something in his brain was affecting his ability to communicate. He was a legend. RIP.
0:42 diazepam, midazolam, but you can use ketamine and suxamethonium if you’re feeling frisky… and if you have an ambu nearby when the patient stops breathing.
During a psychotic episode I had, I was completely out of control. Attacking people as they came close, biting myself, scratching and grabbing on to people. The paramedics couldn't deal with me so I was taking the emergency room in an ambulance. I was too difficult to handle, they couldnt do anything like blood pressures or IV lines so they held me down and dosed me with Ketamine. Knocked me out in a minute or so and I was out for days. Although that was probably more due to exhaustion. Im grateful to all the health workers that have to deal with the mentally ill. I imagine it must difficult to make hard decisions like that to help someone in need.
Great video. I'm in America and I work in a group home for people with mental health disorders. Here I see quite a few people are prescribed haldol, probably 20-30% of the time. Olanzapine seems to be the main go to here, most are on it.
would guess that the "Italian" accented guy was trying to portray Foreign Accent Syndrome (not sure if that's the official term). I remember learning that there have been documented cases of people following a TBI and/or stroke that suddenly began speaking in a way that sounds like a foreign accent
Never stopped taking antibiotics early but I'm on medication for Crohn's and depression on/anxiety but also he have suspected ADHD (waiting for assessment) and I really struggle to keep up with meds just because I often forget.
I use a 28 day pill keeper and I *still* forget a few times a month. I'll open it and the prior day hasn't been taken. It was *really* bad on two statin drugs. One was pravastatin, the other I literally can't remember the name of (and it was causing me to forget things while i was taking it).
@@macmcleod1188 I have my daily to do list on a big whiteboard, with every stupid little thing I need to do (even things like brushing teeth or getting dressed) and taking meds is the second thing on my list. Usually I never forget these daily things, but its nice to have an easy reminder to tick off, so I dont spend 20 minutes thinking about what it is I might have forgotten
@@nadiar.4638 I've been doing it for decades now... and so if I make a note and it's not ticked off-- I'm not sure if I did it and simply forgot to mark the checklist. Lol.
Did you air quote multiple personalities because the proper term is dissociative identity disorder or some other reason such as a distain for Hollywood portrayals of the disorder, or some other reason?
Apropos your inquiry I believe the seemingly Italian fella was afflicted by Foreign Accent Syndrome. Perhaps a scooter related injury damaged his frontal lobe. Though as a person who has experienced an open head injury and wears many scars Im curious why I cannot see any clear signs of damage to his forehead. Love the show Dr. C
You said haloperidol in the UK is not a common anti-psychotic, working in a general hospital on the elderly care/dementia ward it is an extremely common PRN drug I see almost daily for my extremely unsettled and agitated patients. Is this not best practice and why do you think this might be?
Haldol and/or Ativan, best IM tranqs. Haldol is no longer a first-line antipsychotic, but for people who don't respond to the atypicals or who experience significant side effects, sometimes Haldol is used alongside Cogentin for the tardive dyskinesia.
i was given haldol via iv while under the influence of alcohol in the ER. it was horrible, i woke up in a psych ward 2 days later with no recollection of the events and believing i was dreaming while awake
As for the IM shot I would still say Haloperidol, particularly around the time this was filmed, but honestly, even today. I don't know about the UK, but in central europe where I live Haloperidol is still very much a popular and commonly used drug when it comes to acute situations where urgent intervention is in order, for example when there are psychosis including violence or self-harm. Benzodiazepines are also still very much common for sedation, but they're obviously not antipsychotic medication, so they would be used if phobia was in the mix. (With that said, fortunately there is a trend of moving away from Benzodiazepines when it comes to something like "just" insomnia. Look 15, 20 years back and there were loads of people who were just prescribed Benzos as their first medication when they brought up sleep disorder, especially elderly people. Nowadays, people are more cautious in regards to introducing Benzos as an ongoing medication early on in cases with "minor" issues. Sure, sometimes you need them, but people are more conscious about potentially putting someone on a lifelong addiction in cases where other interventions might have the same positive effect without that risk)
I don’t know about “tranquillisation” but you could use rocuronium as a muscle relaxant - and it’s one of the few things which might work fast enough to cause muscle floppiness in less than an elevator ride. I’ve mainly heard of it as an emergency drug used in intubation to prevent the patient from gagging on the tracheal tube. It works so quickly that a patient can have their trachea relaxed and intubated in 2 minutes flat. If it was actually tranquilising him him not sure. Strong benzodiazepines? You’d have to make sure you didn’t kill him by accident xD
Rocuronium works quickly but in this case she'd just kill him if she used it because he wouldn't be able to breathe with the muscle relaxation. Great drug for intubating someone, but don't ever use it outside of that.
typical antipsychotic medications like haloperidol and droperidol and less commonly used atypical antipsychotics like olanzipine. Also benzodiazepines are used however some are used more often than others. I'm not sure but lorazepam is definitely used and maybe midazolam. Benzodiazepines that take longer to work may not be used. I'm also unsure about that.
@@ered203 I've heard of olanzipome being used intramuscularly online but I've never really seen the reasoning for it as usually haloperidol is very quick at working
@@jismy012 I couldn't even begin to tell you the reasoning. They were in the process of shooting me full of drugs at the time so it was not my best cognitive moment. ;) All I really remember is them coming at me with a needle, me asking if it was haldol, and the NP saying, "Nope, Zyprexa." I do remember saying, "Well, la dee da," and people laughing. I like to keep it light even in the middle of a complete psychiatric breakdown. It's because I'm a damn people person.
Nope. I always take all the medication especially if it involves antibacterial. Learned as a child how bad it is to stop early and helps the bacteria to adapt.
Geodon is the brand name for ziprasidone, right? Not something we use here so I have zero experience with that one. Olanzapine can be, esp if the agitation is driven by untreated psychosis
@@DoctorElliottCarthy And is utterly useless if the agitation is caused by dissociation, the most oft misdiagnosed thing in psychiatry today, because it usually presents similarly to bipolar disorder. Ever notice that meds just don't seem to work for some bi-polar or schizophrenic people? Check the diagnosis, then double check it, then send the case to another pair of eyes and check again.
I'm not sure what they were going for with the guy speaking fake Italian, but I got the vibe it might be something that you see in some some Americans that have a tendency to lie compulsively and tell others they're foreign born or a foreign national. I thought it might have been a joke about how insecure many people can be in their identity, but it could be a bad DID joke given its 2004 or whatever
Good thoughts. We wouldn't use midaz usually as it can affect you're breathing and psych hospitals arent best equipped to manage that risk. Ketamine isn't used as tranq but it is used as a general anaesthetic esp. In trauma settings. It can cause psychosis though which would just make things worse for someone with schizophrenia that we might be treating
@@DoctorElliottCarthy As for the ketamin, true. But to manage the psycosis as follows. I know it is used for any combative patient that cannot be managed otherwise with 500 Ket and 5 Midazolam, atleast here. Is that bcs of the UK that it isnt used as often? In my country it is equiped on every ambulace for this reason and for trauma use in minors.
Absolutely Haloperidol is a commonly used sedative esp in small doses in the elderly with delirium if push comes to shove (though ideally no drugs should be used if possible)
Diphenhydramine is not something we really use in the UK. We use promethazine which is also an H1 receptor antagonist but it's funny to see the small differences in practice
first thought benzos, second thought antipsychotics, third was um...ketamine but that's not the right branch of medicine I think :P ughh...first gen antihistamines probably not eith...oh wait hydroxyzine all over the place in Poland if you want something "lighter", like for that one annoying kid that won't stay quiet (joke)
I would suggest lorazepam instead of diazepam for tranquilisation, as its more sedative and has a short half life compared to diazepam which is anxiolytic and has a long half life. I'm not sure about loxapine as that's not something we use in the UK? Can you tell me more about it?
@@DoctorElliottCarthy Loxapine is a sedative atypical antipsychotic.It's available in France which has trade name "Loxapac" and I'm not sure if it's used in the UK. It's normally used in the emergency psychiatry unit for severe agitation state and aggressive behavior especially in psychotic disorders. Thanks so much Dr. Elliott Carthy. I'm a psychiatric resident and I really love watching your videos because it's really help me a lot especially the psychoanalysis which I am really null about it. ^^
@@DoctorElliottCarthy lorazepam doesn't seem to work very well on me. Even though I don't regularly use any members of that family of drugs, lower doses of all of them seem ineffective.
Can't say what not-Italian-guy suffers from, but I don’t think it is psychosis. I think he just wants to be someone he isn't really badly so he fakes being Italian. It might not even be why he is there, he could have something else, especially since she is kind of off hand about him not being Italian, but this is something he is doing as well, either as a personal issue or as part of his syptoms, such as being so depressed and self-hating he decided to try to be like someone else, like what he would like to be. Scarily, it may even be part of his therapy to get him out and living life. Maybe Jim can't get up and ride a scooter and dress like that and express his distate for American society, but Massimo can!
I had a resident in a nursing home who was always blowing kiss and touching all the women. We didn't want to give him pills to make him sleepy so he wouldn't sexual assault anybody (he was a strong old man who had been known to place his hands where they were not allowed!) but we did need to take some action so he was given an adult magazine to keep in his room. When he was all fired up he was gently guided to his room and his magazine
fun fact: in vet med, we use haloperidol to stop feather picking in birds (when it can't be fixed any other way)
Checks out, I use it to dampen my Tourette syndrome :P
Worth remembering this episode aired in 2004, so while I have no clue what drugs were and weren't commonly administered back then, it wouldn't be a surprise if many of them were no longer regularly prescribed 16 years later.
"Heck, if you've been out of med school five years, half of what you learned is obsolete." - Dr. Kelso
I like your math. I wish it was still 2020.
@@betonkevero6823 This video was uploaded in 2020
@@SupermewX300 the comment is 8 months old
@@betonkevero6823 Yes?
@@SupermewX300 ummm, yeah!?
When I worked as a paramedic on an ambulance in the US, we carried Versed (midazolam). The hospitals seemed to favor Ativan.
Ativan is the brand name for lorazepam right? We don't use brand names in the UK so I always get in a muddle. Loraz is preferred here too.
@@DoctorElliottCarthy Yes, Ativan is lorazepam. Midazolam usually worked well; however I've given 10 mg, in 2 doses, to someone high on crack and meth with no effect.
@@DoctorElliottCarthy In our ED, at least when it comes to violently psychotic patients, we use the very nicely named B52 shot, which is 50mg of Benadryl (Diphenhydramine), 5mg of Haldol, and 2mg of Lorazepam. That will usually sedate them enough for us to hook up an IV and actually get something going before we can transfer them to med surg while we try to find psych placement.
@@DoctorElliottCarthy I wish the U.S only used the generic names, would make life a lot easier.
Standing around in rotations with a blank face because I didn't know that Zosyn was Piperacillin/Tazobactam.
@@jamesmantil5186 which sort of makes us drug users more educated.. we know what we want / need and all the different names.
Speaking about SCRUBS, how about taking a look at 3x14 "My screw up" about how people choose to deal with grief... Particularly someone like dr Cox.
Oh man that episode broke me
Hope to see more Scrubs videos! Subscribed for it. Have a good one, everyone and stay safe!
New to the channel. Loving it so far. I recommend watching the episode "My five stages" where JD and Dr. Cox deal with the terminal diagnosis of a long term patient at the hospital.
For the not Italian guy I’d assume it’s referencing foreign accent syndrome. It tends to come up as a quick joke in a lot of medical shows like this, but I’m not an expert and I’ve only really heard of it in passing tbh.
To me it seems like masking he has some disorder and masks his real mannerisms to apear normal or socially acceptable
Actually was just gonna write this myself. I learned about it in school that there are documented cases of it resulting after a patient has suffered a TBI or Stroke.
Or Molly was making a "joke"
Maybe she was using touch to help with learning his name, Ive read in learning the more senses used in "learning" leads to a stronger retention.
I love watching professionals react to Scrubs and Always Sunny and other awesome shows 😋
Like Leagle Eagle?
@Niko Aldo Yup, I've been using flixzone for since november myself :D
@@nikoaldo4394
Spammer
@@curtisrobert2519
Ooh a bunch of accounts less than a week old all agreeing with the spammer?
🙄
I'm certainly guilty of stopping my psyche meds... Though I did have a good reason, I used to have chlonidine to treat motor tourrettes, but the specific brand I took was discontinued the year I started taking it and the supply dried up. I was put on a more generic version of the drug... And after a couple days of throwing up blood, I stopped taking it. It's worth adding to this my prescriptions are generally incredibly high dosage in general as I have an abnormally strong resistance to drugs and toxins. So if there is a particularly bad side effect, it's more likely to occur... I also have hypersensitive touch and feel pain at a magnitude of roughly x3-x9 so that wasn't fun at all (cause yeah... No amount legal of morphine is numbing that)
Speaking of haloperidol and weird side effects, i took one by accident once. The guy who gave it to me said it was klonopin ( a xanax like benzo) and when that pill kicked in my body was locking up BAD, first it was my jaw, it locked so bad i broke a tooth, then i started having trouble walking, and not like im dizzy, but more like certain muscles just werent working, I imagine it was a very odd sight, last thing ill mention is it made my abs cramp so bad i was screaming in pain, and wound up in the hospital.
So your body started to lag, lock-up, freeze, and eventually blue screen?
Yeah, that doesn't sound pleasant.
did it leave any longstanding effects ?
I always assumed that he was just a liar and the Italian affectation was secondary, or not at all, related to why he was seeing the psych.
You NEED to make more videos..(please)
Benzodiazepines and haldol can be used Intramuscularly...
Great input all around! Best comment was i love scrubs. We do too
More scrubs!
Not-so-fun-fact: Terry Jones of Monty Python had frontotemporal dementia for some years before his passing. I'm not sure particularly how it affected him, but from my understanding, he lost most of his ability to speak, not because he physically couldn't, but rather something in his brain was affecting his ability to communicate. He was a legend. RIP.
0:42 diazepam, midazolam, but you can use ketamine and suxamethonium if you’re feeling frisky… and if you have an ambu nearby when the patient stops breathing.
During a psychotic episode I had, I was completely out of control. Attacking people as they came close, biting myself, scratching and grabbing on to people. The paramedics couldn't deal with me so I was taking the emergency room in an ambulance. I was too difficult to handle, they couldnt do anything like blood pressures or IV lines so they held me down and dosed me with Ketamine. Knocked me out in a minute or so and I was out for days. Although that was probably more due to exhaustion. Im grateful to all the health workers that have to deal with the mentally ill. I imagine it must difficult to make hard decisions like that to help someone in need.
Hope you are doing okay! Thank you for sharing your story.
Great video. I'm in America and I work in a group home for people with mental health disorders. Here I see quite a few people are prescribed haldol, probably 20-30% of the time. Olanzapine seems to be the main go to here, most are on it.
I would really love you to react to the show Crazy Ex-Girlfriend, it's a musical show and full of people with interesting coping methods!
would guess that the "Italian" accented guy was trying to portray Foreign Accent Syndrome (not sure if that's the official term). I remember learning that there have been documented cases of people following a TBI and/or stroke that suddenly began speaking in a way that sounds like a foreign accent
B52 is used in America. Sometimes a Z52...50 of Benadryl, 2 of Ativan, and 5 of Haldol or Zyprexa
Never stopped taking antibiotics early but I'm on medication for Crohn's and depression on/anxiety but also he have suspected ADHD (waiting for assessment) and I really struggle to keep up with meds just because I often forget.
Remembering meds is so fucking hard with adhd, missing a venlafaxine dose was always killer
I use a 28 day pill keeper and I *still* forget a few times a month. I'll open it and the prior day hasn't been taken. It was *really* bad on two statin drugs. One was pravastatin, the other I literally can't remember the name of (and it was causing me to forget things while i was taking it).
My mom had a fancy pillbox with an alarm as part of it and it made a difference because she could not remember whether she had taken medication or not
@@macmcleod1188 I have my daily to do list on a big whiteboard, with every stupid little thing I need to do (even things like brushing teeth or getting dressed) and taking meds is the second thing on my list. Usually I never forget these daily things, but its nice to have an easy reminder to tick off, so I dont spend 20 minutes thinking about what it is I might have forgotten
@@nadiar.4638 I've been doing it for decades now... and so if I make a note and it's not ticked off-- I'm not sure if I did it and simply forgot to mark the checklist.
Lol.
The Italian guy could have Histrionic Personality Disorder.
Did you air quote multiple personalities because the proper term is dissociative identity disorder or some other reason such as a distain for Hollywood portrayals of the disorder, or some other reason?
I would like to see him react to something like split and see his take on D.I.D. the air quotes make me curious on his thoughts
Apropos your inquiry I believe the seemingly Italian fella was afflicted by Foreign Accent Syndrome. Perhaps a scooter related injury damaged his frontal lobe. Though as a person who has experienced an open head injury and wears many scars Im curious why I cannot see any clear signs of damage to his forehead. Love the show Dr. C
I can't get over how much you look like Adam Buxton
Binging your stuff
You said haloperidol in the UK is not a common anti-psychotic, working in a general hospital on the elderly care/dementia ward it is an extremely common PRN drug I see almost daily for my extremely unsettled and agitated patients. Is this not best practice and why do you think this might be?
Haldol and/or Ativan, best IM tranqs. Haldol is no longer a first-line antipsychotic, but for people who don't respond to the atypicals or who experience significant side effects, sometimes Haldol is used alongside Cogentin for the tardive dyskinesia.
i was given haldol via iv while under the influence of alcohol in the ER. it was horrible, i woke up in a psych ward 2 days later with no recollection of the events and believing i was dreaming while awake
from what i’ve read, haldol should not be given through iv or when you’re aware a person is intoxicated
As for the IM shot I would still say Haloperidol, particularly around the time this was filmed, but honestly, even today.
I don't know about the UK, but in central europe where I live Haloperidol is still very much a popular and commonly used drug when it comes to acute situations where urgent intervention is in order, for example when there are psychosis including violence or self-harm.
Benzodiazepines are also still very much common for sedation, but they're obviously not antipsychotic medication, so they would be used if phobia was in the mix. (With that said, fortunately there is a trend of moving away from Benzodiazepines when it comes to something like "just" insomnia. Look 15, 20 years back and there were loads of people who were just prescribed Benzos as their first medication when they brought up sleep disorder, especially elderly people. Nowadays, people are more cautious in regards to introducing Benzos as an ongoing medication early on in cases with "minor" issues. Sure, sometimes you need them, but people are more conscious about potentially putting someone on a lifelong addiction in cases where other interventions might have the same positive effect without that risk)
I don’t know about “tranquillisation” but you could use rocuronium as a muscle relaxant - and it’s one of the few things which might work fast enough to cause muscle floppiness in less than an elevator ride.
I’ve mainly heard of it as an emergency drug used in intubation to prevent the patient from gagging on the tracheal tube. It works so quickly that a patient can have their trachea relaxed and intubated in 2 minutes flat.
If it was actually tranquilising him him not sure. Strong benzodiazepines? You’d have to make sure you didn’t kill him by accident xD
If you use paralyse him without resp support I think he will die -_-;;
Rocuronium works quickly but in this case she'd just kill him if she used it because he wouldn't be able to breathe with the muscle relaxation. Great drug for intubating someone, but don't ever use it outside of that.
I'd be interested in some analyses of Community episodes
Haldol. Seen it used in person when I was at Balboa Naval Medical Center.
typical antipsychotic medications like haloperidol and droperidol and less commonly used atypical antipsychotics like olanzipine. Also benzodiazepines are used however some are used more often than others. I'm not sure but lorazepam is definitely used and maybe midazolam. Benzodiazepines that take longer to work may not be used. I'm also unsure about that.
Yeah, I was thinking that Zyprexa (olanzapine) was pretty commonly used, but maybe it was just because that was what the ER docs used on me.
@@ered203 I've heard of olanzipome being used intramuscularly online but I've never really seen the reasoning for it as usually haloperidol is very quick at working
@@jismy012 I couldn't even begin to tell you the reasoning. They were in the process of shooting me full of drugs at the time so it was not my best cognitive moment. ;)
All I really remember is them coming at me with a needle, me asking if it was haldol, and the NP saying, "Nope, Zyprexa."
I do remember saying, "Well, la dee da," and people laughing. I like to keep it light even in the middle of a complete psychiatric breakdown. It's because I'm a damn people person.
Nope. I always take all the medication especially if it involves antibacterial. Learned as a child how bad it is to stop early and helps the bacteria to adapt.
JD going in for the hug. Lmao why would you???
Good old 5 & 2!
More SCRUBS please
Geodon and olanzapine are pretty common IM at my hospital.
Geodon is the brand name for ziprasidone, right? Not something we use here so I have zero experience with that one. Olanzapine can be, esp if the agitation is driven by untreated psychosis
@@DoctorElliottCarthy And is utterly useless if the agitation is caused by dissociation, the most oft misdiagnosed thing in psychiatry today, because it usually presents similarly to bipolar disorder. Ever notice that meds just don't seem to work for some bi-polar or schizophrenic people? Check the diagnosis, then double check it, then send the case to another pair of eyes and check again.
I have only seen haldol and ativan used IM
I think it's a paralytic...you should check out S04E03...love the dialog between Dr. Cox and Dr. Clock
Haldol and Adavan 5 and 2
I think the Sopranos could make for some great reactions, what with Tony and Dr Melfi (another hot shrink) and all the scenes with that
Doctors are always learning, that's why it's called medical "practice". At least that's what I've been told.
5:43 foreign accent syndrome: a condition caused by neurological changes from damage to the frontal lobe after severe brain injury
I'm not sure what they were going for with the guy speaking fake Italian, but I got the vibe it might be something that you see in some some Americans that have a tendency to lie compulsively and tell others they're foreign born or a foreign national. I thought it might have been a joke about how insecure many people can be in their identity, but it could be a bad DID joke given its 2004 or whatever
MPD isn’t a used term now it’s DID. I have it.
Haldol, Ativan, and Benadryl
Good answers. In the UK we use promethazine rather than diphenhydramine but the principle.is the same 😊
its called small talk not my depressive life in 30 segs
Some short acting benzos like midazolam, lorazepam.
Antipsycotics like haldol.
Hypnotics like Ketamin.
Good thoughts. We wouldn't use midaz usually as it can affect you're breathing and psych hospitals arent best equipped to manage that risk. Ketamine isn't used as tranq but it is used as a general anaesthetic esp. In trauma settings. It can cause psychosis though which would just make things worse for someone with schizophrenia that we might be treating
@@DoctorElliottCarthy As for the ketamin, true. But to manage the psycosis as follows. I know it is used for any combative patient that cannot be managed otherwise with 500 Ket and 5 Midazolam, atleast here.
Is that bcs of the UK that it isnt used as often? In my country it is equiped on every ambulace for this reason and for trauma use in minors.
Not a medical person but what if it was just a syringe full of air. I imagine an air embolism would be pretty awful.
It would be far from ideal to put it mildly
Larazopan maybe?
I have one question. The singing guy does he just do that all by himself or is he under music therapy?
Love me some Heather Graham
I use seroquel rather than halo.
How can I get you to be my psychiatrist? Do you make house calls to the US?
oh the "chemical restraint" these days is ketamine, it's non-addicitve, quick acting and fairly safe
Haladol? I come from veterinary medicine so unsure if this is fully correct!
I think she hit him with a horse sized dose of ketamine.
Lorazepam of haloperidol
Haldol or Olanzipine/Respiridone
Or even a strong side of Lorazepam?
Ativan and haldol for the patients I've dealt with
Haloperdol 5mg and lorazepam 2mg
Any benzodiazepine really, though I'd say lorazepam would be a top pick, diazepam, or alprazolam
Except behavior modification is more a product of operant (aka instrumental) conditioning rather than classical conditioning.
Haldol, Geodon!
i know its a year late, but ketamine. i guess pcp too, but probably ketamine. so he probably had a k hole in the elevator haha.
Haldol or haloperidol? Maybe lorazepam. For the sedation, i mean.
Dexter uses ketamine to knock out his victims. You should react to that show, lots of weird and probably totally inaccurate psychology stuff in that.
What's the name of the episode
haldol and thorazene?
Would haloperidol also work that way?
I meant as sedative too... And not just antipsychotic
Absolutely Haloperidol is a commonly used sedative esp in small doses in the elderly with delirium if push comes to shove (though ideally no drugs should be used if possible)
Love the Far side csrtoon with the shrink writing "just plain nuts" about a pasient.Not exactly PC, fun though.
I've always been partial to the b52 if someone is really out of control. 50mg benadryl (the b. Diphenhydramine), 5mg haloperidol, 2mg Ativan.
Diphenhydramine is not something we really use in the UK. We use promethazine which is also an H1 receptor antagonist but it's funny to see the small differences in practice
first thought benzos, second thought antipsychotics, third was um...ketamine but that's not the right branch of medicine I think :P ughh...first gen antihistamines probably not eith...oh wait hydroxyzine all over the place in Poland if you want something "lighter", like for that one annoying kid that won't stay quiet (joke)
Haldol?
all the Quetiapine
No!!!
Haloperidol or lorazepam？
HALDOL!
Ketamin is used intra muscularly i think :D
Hope you didn't just out yourself buddy ;)
Larazzzzz everyone uses it I wish they wouldn't
Loxapine and Diazepam.
I would suggest lorazepam instead of diazepam for tranquilisation, as its more sedative and has a short half life compared to diazepam which is anxiolytic and has a long half life. I'm not sure about loxapine as that's not something we use in the UK? Can you tell me more about it?
@@DoctorElliottCarthy Loxapine is a sedative atypical antipsychotic.It's available in France which has trade name "Loxapac" and I'm not sure if it's used in the UK. It's normally used in the emergency psychiatry unit for severe agitation state and aggressive behavior especially in psychotic disorders. Thanks so much Dr. Elliott Carthy. I'm a psychiatric resident and I really love watching your videos because it's really help me a lot especially the psychoanalysis which I am really null about it. ^^
@@DoctorElliottCarthy lorazepam doesn't seem to work very well on me. Even though I don't regularly use any members of that family of drugs, lower doses of all of them seem ineffective.
Haloperidol?
Fentanil.
But I am a nurse, so I already knew.
Haldol!
Can't say what not-Italian-guy suffers from, but I don’t think it is psychosis. I think he just wants to be someone he isn't really badly so he fakes being Italian. It might not even be why he is there, he could have something else, especially since she is kind of off hand about him not being Italian, but this is something he is doing as well, either as a personal issue or as part of his syptoms, such as being so depressed and self-hating he decided to try to be like someone else, like what he would like to be.
Scarily, it may even be part of his therapy to get him out and living life. Maybe Jim can't get up and ride a scooter and dress like that and express his distate for American society, but Massimo can!
Ketamine?
I had a resident in a nursing home who was always blowing kiss and touching all the women. We didn't want to give him pills to make him sleepy so he wouldn't sexual assault anybody (he was a strong old man who had been known to place his hands where they were not allowed!) but we did need to take some action so he was given an adult magazine to keep in his room. When he was all fired up he was gently guided to his room and his magazine
❤️
Temazapam
The guy who was over the top Italian, foreign language syndrome?? not a Dr so please forgive me if i'm chatting bubbles 😂
Midazolam
Howlidoll and cogentin i know I botched the spelling.
Maybe the "Italian man" had foreign accent syndrome?
GEODON
rubber mallet is best tranquiliser
Ketamine
I hate the psychiatrist. I have a therapist mom, she can't find everyone's insecurity, she's HUMAN. not a therapist robot
Elliot would have drugged him with a high dose benzo or a neuroleptic.
Can you react to boxing daria?