Midazolam for status epilepticus

Abstract

Midazolam is now the first-line treatment for status epilepticus in children. The drug can be given via several different routes. Transmucosal administration is safe, effective, easier to use and more socially acceptable than rectal diazepam. The aim is to stop convulsive seizures that have lasted longer than five minutes as soon as possible. Transmucosal pre-hospital administration by carers is recommended for patients with a predilection for prolonged seizures, or those with limited access to emergency services. This reduces the time to treat and improves outcomes. General practitioners can obtain midazolam through the Prescriber Bag Drug Supplies section of the Pharmaceutical Benefits Scheme. For pre-hospital use, 5 mg in 1 mL plastic ampoules is recommended.