NORTH COAST EMERGENCY MEDICAL SERVICES Policy #5332
POLICIES AND PROCEDURES
Subject: Medical Control
Diazepam
Associated Policies: 5333, 5416, 6516
I. Indications:
A. Sustained and/or recurrent grand mal seizures.
B. Before cardioversion in conscious patients.
II. Therapeutic Effects:
A. Decreased cerebral irritability.
B. Relaxes skeletal muscles.
C. Sedation.
III. Contraindications:
A. Absolute- Suspected or known allergy to diazepam.
B. Relative
1. Shock
2. Pregnancy.
3. Trauma to rectum (for rectal administration).
4. Congenital or surgical anomaly of the rectum (for rectal administration).
IV. Adverse Effects:
A. Respiratory depression or arrest may be caused or worsened by diazepam.
B. Drowsiness, vertigo, ataxia, transient hypotension.
C. Rectal injury may occur due to forceful entry of the syringe.
D. Inadequate absorption, following rectal administration.
V. Administration of Dosage:
A. Adult-2.5-20 mg IV push in 2.5 mg increments titrated to effect. May give up to 40 mg in status epilepticus. 5-10 mg IM.
B. Pediatric-0.1-0.3 mg/kg slow IV push or 0.5 mg/kg (maximum dose 20 mg) rectally.
VI. Special Information:
A. Never give without resuscitation equipment available.
B. Push as close to the hub as possible. Diazepam may precipitate if mixed with other drugs or IV solutions.
C. Effects of diazepam are potentiated with alcohol and other sedatives.
D. Painful upon IM administration, unpredictable absorption.
Approved: Date:
Approved As To Form: Date: