He is not hypoxic or hypoglycemic (but if there is a suspicion of this, it is easy enough to get a pulse oximetry reading or a finger stick blood sugar).
You can reduce this to “five and one” or increase it depending on the circumstances.
You can also vary the ratio or use just Haldol or just lorazepam depending on a particular case.
These studies demonstrate that intramuscular haloperidol is both safe and effective in the treatment of agitation caused by virtually any etiology” Roberts: Clinical Procedures in Emergency Medicine, 5th ed.
Any other antipsychotic that can be given IM can also be used for rapid sedation.
It almost can be thought of as an “antidote” to stimulant “poisoning.” So the patient who is agitated while “tweaking” on meth would do well receiving lorazepam.
The standard dose of lorazepam for chemical sedation is 1-4mg IM.
In practical terms, this means that if they are combined, you can use a smaller total dose of each agent.
Instead of needing 4mg of lorazepam IM to sedate a patient, if you combine it with Haldol, you only may need 1 or 2 mg and vice versa.
Versed (midazolam) is an acceptable alternative to Ativan.
The main disadvantage of Ativan as a chemical sedative is that it can cause respiratory depression, especially when combined with other sedating drugs.
Possibilities include Inapsine (droperidol), Geodon (ziprasidone), and Zyprexa (olanzapine). The major potential adverse effects of acute one-time dose Haldol administration are exceedingly rare.