Midazolam (Varsed)

Class

Class

• Benzodiazepine: Sedative / Anticonvulsant

Midazolam (Varsed)

Action

Action:

• CNS Depressant
• Produces arteriograde amnsia, then sedation
• Stops and pervents seizures

Midazolam (Varsed)

ONSET

• IV/IO/IN = 2 Minutes
• IM = 15 Minutes

Midazolam (Varsed)

Duration

• 1-4 hours

Midazolam (Varsed)

Seizures: (S-123, S-133, S-161)

• Generalized seizures lasting ≧ 5 minutes
• Focal seizures with respiratory compromise
• Recurrent seizures without lucid interval
• Eclamptic seizures of any duration

Midazolam (Varsed)

Adult

0.1 mg/kg slow IV/IO (1mg/min) to max 5mg.

MR x1

If no IV/IO

0.2 mg/kg IM to max 10mg -or-

0.2 mg/kg IN to max 5mg

MR x1

PEDS

PDC IV/IM/IN

Midazolam (Varsed)

• Unstable Bradydardia: discomfort associated with TCP capture, after Morphine if BP ≧100
• Unstable Conscious VT: precardioversion

Midazolam (Varsed)

ADULT ONLY:

1-5mg slow IV/IO (1mg/min)

If age ≧ 60 consider lower dose with attention to age and hydration status

Midazolam (Varsed)

• Conscious SVT: -precardioversion

Midazolam (Varsed)

ADULT ONLY:

1-5mg slow IV/IO (1mg/min) BHO

If age ≧ 60 consider lower dose with attention to age and hydration status

PEDS:

PDC slow IV (1mg/min) BHPO

Midazolam (Varsed)

• Unstable Conscious A-Fib, A-Flutter: precardioversion

Midazolam (Varsed)

ADULT ONLY:

1-5mg slow IV/IO (1mg/min) BHPO

If age ≧ 60 consider lower dose with attention to age and hydration status

Midazolam (Varsed)

• ? stimulant intoxication with sever agitation

Midazolam (Varsed)

ADULT ONLY

0.2mg/kg IM to max 10mg; MR x1

or

0.2mg/kg IN to max 5mg; MR x1

or

0.1mg/kg IV to max 5mg; MR x1

Midazolam (Varsed)

• Sever agitation

Midazolam (Varsed)

ADULT ONLY:

5mg IM/IN/IV: MR x1 BHO

Midazolam (Varsed)

• None

Midazolam (Varsed)

• Laryngospasm, resiratory depression / apnea
• Drowsiness / confusion / amnesia
• Hypotension

Midazolam (Varsed)

(Concentration: 5mg/1ml or 10mg/2ml) **

** 2012 EMREGENCY DRUG SHORTAGE CONCENTRATION 1mg/1ml is inappropirate for IN/IM dose and CANNOT be used with pediatric drug chart!!**

1. USE WITH CATION in suspected ETOH intoxication.
2. Varsed should be administered slowly at a rate of 1mg/min when given IV/IO
3. 5 minute seizure time includes time prior to arrival of prehospital providers.
4. Discontinue administration if/when seizure activity stops.
5. Carefully monitor adequacy of respiratory status and O2 saturation during administration.
6. Side effects of Versed, i.e. respiratory depression, may be potentiated when combined with the use of ETOH, other sedative hypnotics and other CNS depressants resulting in apnea.
7. When used for cardioversion: amnesia is desired effect, not sedation, therefore the dosage administered will NOT nessarilly rodice lethargy.
8. Versed is treated as a controlled substance and is to be secured / signed for when used.
9. In extremly agitated patient, IM route is usually safer and preferred in order to prevent injury to patient and personnel.  If unable or patient too violent for needles consider IN route.
10. Injection may be given though clothing into the thigh for crew safety issues.
11. Versed is not indicated for simple febrile seizures.