Intramuscular sedatives given for acute agitation can depress breathing and lower blood pressure, particularly when drugs are combined or the person is intoxicated, dehydrated or physically unwell. Established practice is to monitor after each dose rather than assume the person is simply asleep.
Check sedation level, respiratory rate, oxygen saturation, pulse and blood pressure at regular intervals until the person is ambulatory, and follow your unit's protocol for how often. Keep the medication chart accurate so that doses are not repeated unknowingly across shifts.
- Monitor respiratory rate, oxygen saturation, pulse, blood pressure and sedation level after each intramuscular dose.
- Be extra careful when a benzodiazepine and an antipsychotic have both been given.
- Look for a physical cause of agitation, including intoxication, infection and metabolic upset.
- Record doses and times so repeat dosing is deliberate.
Why it matters
A quiet patient after an injection is not necessarily a safe one.
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