Midazolam

Question 1

What are the indications for the use of midazolam (Versed)?

Answer 1

• Seizures (status epilepticus, pre-eclampsia/eclampsia)
• Sedation (cardioversion, pacing, fracture realignment, muscle spasms (with analgesia medication)
• Severely anxious or agitated patients, stimulants, non-cyclic antidepressants, excited delirium syndrome
• Maintenance of sedation for intubated and mechanically ventilated patients
• Sedation prior to intubation in conjunction with fentanyl (MFI)

Question 2

What is the dose of midazolam (Versed) for conscious sedation?

Answer 2

Max dose 2.5 to 5mg (0.05 - 0.1mg/kg) IV q 5 – 10 min.

Muscle Spasm dose is usually 1 - 2mg. If unable to get IV then give 5 - 10mg IM

Question 3

What is the dose of midazolam (Versed) to treat seizures?

Answer 3

Max dose 5mg (0.05 - 0.1mg/kg) SIVP or 10mg IM once.

Use lower dose for patients >65 yrs. of age or pts with smaller body mass.

Max dose 10mg IN (0.2mg/kg), no repeat. Primarily used for pediatric seizures and sedation.

Question 4

What is the dose of midazolam (Versed) in maintenance of sedation for intubation?

Answer 4

Max dose 5mg SIVP (0.2 - 0.5mg/kg), q 5 - 10min prn

Infusion: 1 - 7mg/hr, titrated to the desired amount of sedation. Used for transports 30+ minutes

Question 5

What is the dose of midazolam (Versed) for MFI?

Answer 5

Max single dose of 5mg (0.2 - 0.3mg/kg) IVP with an opioid (if systolic BP <90mmHg; use ketamine)

Question 6

What are the contraindications for midazolam (Versed)?

Answer 6

• Hypersensitivity
• Acute narrow angle glaucoma
• Acute alcohol intoxication