![]() Poster presented at the 26th Annual Scientific Meeting of the Epilepsy Society of Australia 2012 Hobart. Trends in prescribing home midazolam for prolonged seizures in children in suburban and rural northern NSW: a 4 year retrospective analysis. Brown J, Subramanian G, Miteff C, Fardell B, Smith R.Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, et al.The community use of rescue medication for prolonged epileptic seizures in children. Rural adult emergency clinical guidelines. Children’s epilepsy resources for clinicians. The Royal Children’s Hospital Melbourne.Nonintravenous midazolam versus intravenous or rectal diazepam for the treatment of early status epilepticus: A systematic review with meta-analysis. Brigo F, Nardone R, Tezzon F, Trinka E.Infants and children: acute management of seizures. Children and infants with seizures – acute management. A definition and classification of status epilepticus-Report of the ILAE Task Force on Classification of Status Epilepticus. Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, et al. ![]() Of dose from ‘salivary washout’ in dribbly childrenĪnd ‘mg’ and the risk of accidental overdosing ![]() It is always best to review parental understanding and techniques Plastic ampoules may struggle without extra instruction if glass ampoules areĭispensed. Of four years of pre-hospital use we found only two out of 197 families withĬircumstantial evidence of carers abusing the drug. Having a single prescriberĪnd dispenser also reduces the potential for abuse and stockpiling. Midazolam is available in a range ofĬoncentrations and volumes so we restrict prescription to 5 mg in 1 mL plasticĪmpoules, wherever possible, to avoid dosing errors. Treating neurologist and the hospital pharmacy because of the restrictedĪvailability of the plastic ampoules. Provided for use by carers, we recommend nominating only one prescriber and oneĭispenser for each child in order to avoid confusion. Much safer if given where expert airway support is available. 12 WithĪ single dose, respiratory depression is rare. Treatment are unlikely when the guidelines for midazolam are followed. MucosalĪtomisation devices may be available through hospitals or the ambulance service Intranasal administration, delivering half the dose into each nostril. We recommend using a reusable mucosal atomisation device for Intranasal route in children with any awareness during seizures because of the Produce local irritation, stinging, sometimes with eyes watering and a runny TheseĪre given after transfer to an emergency facility if first-line drugs fail toĮffects of transmucosal midazolam are sedation, ataxia, irritability orĮuphoria, and mild respiratory depression. Second-line drugs include phenytoin, phenobarbitone and levetiracetam. 5 Midazolam can also be used to terminate clusters of briefĬonvulsive seizures and manage bouts of non-convulsive status epilepticus. Reduces the time-to-treat period and improves outcomes. ![]() 4 Administering midazolam outside hospital Guideline says that midazolam is the drug of first choice when intravenousĪccess has not been obtained. New South Wales (NSW) Ministry of Health in 2009. Incorporated into a guideline for the management of seizures published by the Which can be given intramuscularly, intravenously or transmucosally. Midazolam is a water-soluble benzodiazepine It isĮffective but can be difficult to use, and rectal administration was less First-line drugsĭiazepam was the first-choice drug for stopping status epilepticus. 2Repeat doses may beĮffective but increase the risk of complications and sometimes inappropriatelyĭelay administration of second-line therapy. Treatment becomes less effective if the seizure lasts longer than 15 minutes. Work best if given soon after the seizure has exceeded five minutes. The drugs resolve the majority of emergency presentations and they Ongoing seizures and thereby avoid the complications of prolonged statusĮpilepticus. 1ĭrugs, such as midazolam, are used to abort There is an increased risk of neuronal compromise following prolonged seizures. Do not last longer than five minutes and resolve without medical intervention.Īny convulsive seizure lasting longer than five minutes should be treated as ![]()
0 Comments
Leave a Reply. |