Expert: Ronald Levy, M.D. - 12/19/2009

Question
Hello, Dr Ronald Levy.

I'd like to use a common scene in fiction for a story I'm writing, but I'm having a bit difficulty drawing conclusions from the information I've researched (mostly wikipedia). Since I like to make sure I'm not making serious blunders when I write something, I hope you can help me.

Basically, I have a character (healthy woman in her mid-20s) who has had severe hemorrhage and is very upset, sometimes not fully recognising people around her, and tries to break free from the room, atacking people on the way if they try to stop her. The doctor then sedates her so she won't harm herself and/or others. Would the tranquiliser used be an anxiolytic or an antipsychotic, or would it be a soporific instead of a tranquilizer?

Afterwards, the woman would be calmer but refuse to cooperate with the doctor (including not eating properly and snatching any IV lines set up to keep her well-nourished) with moments of being upset and trying to leave or throwing close by things at who has upset her. Would the doctor keep her on the same drugs as before or would they be changed?

This is getting fairly long, so I'll just summarise what I'd like to know: what type of drug would the patient be given and would it keep her completely asleep or just groggy (which I suppose means not comprehending or registering what's going on around her but having some reaction to someone speaking to her or touching her)?

Thank you for all your help,
Sara

Answer
First of all, if someone is hemorrhaging, it is not likely that htey would sedate them at all but rather treat her hypovolemia. If they were to treat her, they would probably give her something like Ativan which is a benzodiazepine (an anxiolytic) but in a dose high enough to sedate her. They would also bind her to the bed so she wouldn't hurt herself or others. At the doses necessary to sedate her, she would be groggy and sleepy, but arousable. They would continue on this drug (likely as an IV drip) until she was manageable.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston