- High risk of Cardiovascular Collapse/Death – likely due to adrenaline surge, heat exhaustion and injury. It can happen very suddenly.
- Keep physical restraint to a minimum – Don’t allow patient to forced face down, it’s the most likely way of killing them.
- Sedation – if you’re restraining you will almost certainly need to sedate. IV is best but if access is too risky IM will have to do.
- Aggressive management of underlying issues – esp. hyperthermia and acidosis and look out for rhabdomyolysis and DIC
Refusing treatment = Mental Capacity Assessment [LINK]
|Drug||Route||Typical Dose (mg)||Onset (min)||Duration (min)||Warning|
|Midazolam||IV||2-5||1-5||30-60||Respiratory depression, IM unpredictable onset|
|Haloperidol||IV||5-10||10||180-360||Arrhythmia Risk: Only if previously used OR ECG|
|Ketamine||IV||1-2mg/kg||1||20-30||Theoretical risk of worsening cardiovascular instability|