Community use of intranasal midazolam for managing prolonged seizures.
BACKGROUND
Until a few years ago, rectal diazepam (RD) was the only option available to parents and carers managing prolonged seizures. However, its use in the community was limited due to the requirement for privacy, and because education staff in South Australia are not permitted to carry out invasive procedures.


METHODS
Following a literature review, a seizure management training package was developed to enhance the implementation of a trial treatment protocol for the administration of intranasal midazolam (INM). Parents, carers and education staff were later surveyed about their experiences and perceptions.


RESULTS
Intranasal midazolam was administered to 131 people (51 children and 80 adults), with 96.9% control of seizures, and only one minor adverse event. Parents expressed a preference for INM over RD because of the shorter time it took to take effect and wear off, and the ability to administer it in public if necessary.


CONCLUSIONS
Intranasal midazolam is a safe and practical alternative to rectal diazepam for managing prolonged seizures in the community.
Kyrkou
Margaret
M
Children, Youth and Women's Health Service, South Australia. kyrkou.margaret@cyh.sa.gov.au
Harbord
Michael
M
Kyrkou
Nicole
N
Kay
Debra
D
Coulthard
Kingsley
K
D000281:Administration, Intranasal; D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D003156:Community Mental Health Services; D003256:Community Participation; D003975:Diazepam / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004495:Education of Persons with Intellectual Disabilities; D005260:Female; D016352:Group Homes; D006701:Home Nursing; D006801:Humans; D007223:Infant; D007318:Inservice Training; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010290:Parents / Q000193:education; D012640:Seizures / Q000188:drug therapy*; D013021:South Australia; D013226:Status Epilepticus / Q000188:drug therapy*
D000927:Anticonvulsants; D003975:Diazepam; D008874:Midazolam