A 38-year-old man with schizophrenia is brought to ED by police after a disturbance.
He is extremely agitated and shouting, and is trying to assault staff. Verbal de-escalation has failed, oral medication is refused, and physical restraint is required.
His usual medication is olanzapine 15 mg daily. He weighs about 80 kg.
According to current RCEM guidance, what is the most appropriate first-line parenteral agent?
A
IM haloperidol 5 mg with IM promethazine 50 mg
B
IV haloperidol 10 mg as an immediate rapid bolus
C
IM lorazepam alone as the initial sedative drug
D
IM droperidol 5 to 10 mg under close monitoring
E
IM chlorpromazine 100 mg with a prior fluid bolus