Evaluation for reversible clinical and lab abnormalities
Hyperthermia: Remove clothing, misting/airflow, ice packs , cold IV fluids
Acidosis: IV fluids; bicarb controversial
Rhabdomyolysis: IV fluids
Hyperkalemia
Prioritize chemical sedation although some physical restraint is always required
Benzodiazepines, Neuroleptics
Ketamine use increasingly described but may be related with increased side effects such as intubation when used at max IM dosing
4-5mg/kg IM
1-2mg/kg IV
Consider IV olanzapine 2.5-5mg IV q5-10min to max dose of 20mg
In place of IV haloperidol, which is approximately half as potent (~5-10mg haloperidol = ~2.5-5mg olanzapine)
May be safer in patients with prolonged QTc or those too agitated to obtain ECG
IV olanzapine may be as safe or safer than IM, with faster onset
4-5mg/kg IM
1-2mg/kg IV
In place of IV haloperidol, which is approximately half as potent (~5-10mg haloperidol = ~2.5-5mg olanzapine)
May be safer in patients with prolonged QTc or those too agitated to obtain ECG
IV olanzapine may be as safe or safer than IM, with faster onset
Excited delirium
Neuroleptic Malignant Syndrome 
Acute psychosis
Hyperthermia
Delirium tremens
Altered Mental Status 
Delirium
Transient global amnesia