Indications: Active generalized motor seizure.
Midazolam: If the patient is unresponsive (and in seizure) and is not hypoglycaemic and does not have a sensitivity or allergy to midazolam administer 0.1mg/kg IV (to a maximum dose of 5mg) or 0.2mg/kg IM (to a maximum does of 10mg) or 0.2mg/kg IN (to a maximum does of 10mg) or 0.2mg/kg Buccal (to a maximum does of 10mg).
If after 5 minutes the condition persists administer a 2nd dose.
Pediatric Dosing Chart
- Administer 100% O2, manage airway and ventilate as indicated.
- Initiate continuous cardiac monitoring and pulse oximetry (if available).
- Perform blood glucometry. If blood glucose is < 4 mmol/L, treat as for Altered LOC-Suspected Hypoglycemia Protocol before proceeding with this protocol.
- Establish IV line. If after 2 attempts or 3 minutes, IV/IO access has not been secured, Midazolam administered IM, IN or buccally.
- Alternatively, if no IV is available administer Midazolam (if available) 0.2 mg/kg intramuscularly (IM), intranasal (IN), or transmucosal (buccal) to a maximum single dose of 5 mg.
- If the seizure stops during the administration of the drug, terminate the administration.
- If the seizure continues or recurs, repeat administration of Midazolam after five (5) minutes to a maximum of two (2) doses by protocol.
- Monitor respiratory status and initiate transport.
• Contact BHP if other intervention/management is required including treatment of focal seizures.