| Class: |
Benzodiazepine |
| Route: |
- IV or IO, slow push
- IM (alternate route)
- Rectal (preferred route for pediatric patients and alternate route for adults)
|
Adult Dose: |
- Standing order doses of 2.5 mg – 5 mg (up to a maximum of 10 mg) titrated to achieve desired results
- BIOTEL AUTHORIZATION required for sedation to facilitate endotracheal intubation
- BioTel may order additional doses beyond 10 mg.
|
| Pediatric Dose: |
For relief of seizure – standing order
- 0.5 mg/kg per rectum (PR) for relief
All other indications require BioTel authorization |
| Drug Action: |
Central nervous system depressant that causes:
|
|
| Onset: |
(IV) 1 min - 5 min |
(IM) 15 min - 30 min |
(Rectal) 5 min - 15 min |
| Duration: |
(IV, IM) 15 min - 60 min |
(Rectal) 2 hours - 4 hours |
| Indications: |
- Active seizure/status epilepticus or seizure related to eclampsia
- Sedation prior to cardioversion or transcutaneous pacing in conscious patients or to facilitate endotracheal intubation
- Chest pain or tachycardia following an overdose or ingestion of a stimulant or hallucinogen (cocaine, amphetamine, ecstasy, LSD, PCP, ketamine)
- Excited delirium (sedation in struggling patients when medical restraints are applied)
- Maintain sedation following advanced airway placement using the pharmacologically assisted intubation procedure
|
| Precautions: |
- Monitor respiratory status closely
- Administer at site closest to IV catheter and avoid mixing with any other drugs and solutions; flush well before and after use
- Titrate in small boluses to avoid side effects
|
| Side Effects: |
- Respiratory depression
- Hypotension
- Confusion
|
- Stupor
- Vein irritation, phlebitis and sclerosis
- Nausea
|
| Contraindications: |
- Pregnancy (except for eclamptic seizure otherwise use only with BioTel
authorization)
- Alcohol or other sedative drug use
|
- Head injury
- Hypersensitivity
|