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I would see if I can find an underlying reason for the patient being combative and attempt to medicate for that instead of simply sedating because the patient is combative.here's my question for you (or anyone else for that matter)
What would you with a combative trauma pt with low-ish bp that is combative? Morphine or valium?
I wouldn't limit my choices to just those 2 agents, if I had any choice in the matter. In particular, I would expect that some of the agents that are already listed in this thread would be somewhat decent choices for use in that particular situation, that being attempting to control a combative patient with a low-ish blood pressure who is in severe pain.
If I had to limit my choices to morphine and/or Valium, I would possibly consider using Benadryl along with the morphine in an attempt to limit the hypotension that morphine can cause because it does result in a histamine release. I would then consider probably using some small amount of Valium, as it would be potentiated by the morphine and thus hopefully requiring only smaller amounts of it to provide the desired results without too much drop in blood pressure.
Otherwise, I would very much expect that there are better agents than those two that could be used to medicate a patient that is in great pain happens to be also combative. Of course your other ultimate option would be to RSI the patient… That, of course, has its own risks… Some very serious ones, and I would not consider performing at RSI on a patient simply because he or she is combative.