Diazepam (Valium)

 

INDICATIONS:

 

  • Major motor seizures
  • Status epilepticus
  • Pre-medication prior to cardioversion, transcutaneous pacing
  • Skeletal muscle relaxant
  • Acute anxiety states
  • Medication for combative patients and difficult intubations

 

ADMINISTRATION:

 

  • IV, IO, IM Per Rectum in Pediatrics and Adults

 

DOSAGE:

 

ADULT:

 

  • Slow IV administration; titrated to effect up to 15 mg (by Standing Order/Protocol)
  • IV Doses GREATER THAN 15 mg require Direct Medical Order
  • Rectal 10 mg maximum on initial dosage. May be repeated two times - not to exceed 30 mg Maximum Dose.

 

PEDIATRIC:

 

  • IV 0.2 mg/kg titrate to effect, max dose 10mg or 0.75 mg/kg which ever is less
  • PR 0.5 mg/kg, may repeat 0.25 mg/kg in 10 minutes if needed

 

THERAPEUTIC EFFECTS:

 

  • Suppresses the spread of seizure activity through the motor cortex of the brain
  • Effective skeletal-muscle relaxant

 

RELATIVE CONTRAINDICATIONS:

 

  • Respiratory depression
  • Hypotension
  • ETOH or other sedative drugs
  • Pregnancy
  • Hypersensitivity to drug

 

SIDE EFFECTS:

 

  • Respiratory/Cardiac arrest
  • Decreased LOC
  • Hypotension

 

SPECIAL NOTES / RESTRICTIONS:

 

  • This is a Schedule CIV Drug.
  • Relatively short-acting when given IV; seizure activity may reoccur; additional doses may be required
  • No mixing with other drugs because of precipitation
  • After administration patient must be closely monitored with vital signs taken and recorded Q 5-10 minutes if possible IV Doses GREATER THAN 15 mg require Direct Medical Order Iatrogenic dose related complications may be improved with reversal using Flumazenil. CANA Autoinjector may be used one time only without Medical Control Authorization in bioterrorism incidents With suspected nerve agent present. Paramedic members of the state‚Äôs COBRA teams and State certified paramedics are authorized to use the Autoinjector in those instances when a nerve agent is suspected. The CANA Autoinjector delivers a 10MG dose via IM route.