Step 1: no vascular access

NHS Tayside ED Guidance
NHS Tayside

Administer midazolam (buccal):

  • 3-11 months 2.5 mg
  • 1-4 years 5mg
  • 5-9 years 7.5 mg
  • 10-17 years 10 mg

~0.3 mg/kg (max 10 mg)

or

diazepam (rectal):

  • 1 month - 1 year 5 mg
  • 2-11 years 5-10 mg
  • 12-17 years 10-20 mg

~0.5 mg/kg (max 20 mg).

Note: may be administered pre-hospital by trained parents/carers/paramedics or in hospital.

Anticipate next step:get 2nd dose benzodiazepine ready.

5 minutes after 1st benzodiazepine, is the convulsion ongoing? (check ABC)

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