Delirium Clinical Pathway — CICU, PICU, and PCU
Haloperidol and Quetiapine
Haloperidol (Haldol®): > 3 months of age
General Haloperidol Titration Approach
- Increase dose no sooner than the recommended titration frequency by age-based titration increments
- Assess any PRN haloperidol use over the last 24 hours:
- If no PRN(s) given, consider PRN and assessing for response before increasing standing dose
- If PRN(s) required and positive response noted, consider increasing standing dose
- Determine total cumulative dose of haloperidol given in the last 24 hours and divide q6-12h to determine new standing dose (maximum 0.075 mg/kg/dose)
- If no improvement is noted with dose escalations, reassess for non-response and consider discontinuation
Quetiapine (Seroquel®): > 3 months of age
General Quetiapine Titration Approach
- Increase dose no sooner than the recommended titration frequency by weight-based titration increments
- Assess any PRN quetiapine use over the last 24 hours
- If no PRN(s) given, consider PRN and assessing for response before increasing standing dose
- If PRN(s) required and positive response noted, consider increasing standing dose
- If no improvement is noted with dose escalations, reassess for non-response and consider discontinuation