NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 5406

POLICIES AND PROCEDURES

Subject: Medical Control

DIAZEPAM: anticonvulsant and sedative

Valium

Associated Policies:

I. Indications:

A. Sustained and/or recurrent grand mal seizures.

B. Before cardioversion in conscious patients.

II. Therapeutic Effects:

A. Decreases cerebral irritability.

B. Relaxes skeletal muscle tissue.

C. Sedation.

III. Contraindications:

A. Absolute -- Suspected or known allergy to diazepam.

B. Relative -- Shock.

Pregnancy.

Trauma to rectum.

Congenital or surgical anomaly of the rectum.

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, due to lack of venous plexis for uptake.

V. Administration and 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. Very painful upon administration.

Note: EMT-P SCOPE OF PRACTICE ONLY!