What is Buccal Midazolam?

Buccal Midazolam is a type of emergency medication which is used to stop seizures or prolonged seizures. Buccal Midazolam is administered between the cheek and the gum where it is absorbed through the lining.

What is the administration technique for Buccal Midazolam?

1. Preparation: before administering Buccal Midazolam, it is to gather the necessary equipment, such as a prefilled syringe or an oral spray which contains the medication needed; check the expiration date and ensure that the medication is not discolored or damaged. Follow the manufacturer’s instructions for proper storage and handling.
2. Positioning: position the individual in a comfortable and safe position, preferably on their side to prevent choking or aspiration in the case of vomiting. Ensure that their head is turned to the side to allow for drainage of any oral secretions.
3. Administration: if using a prefilled syringe, remove the cap and gently insert the syringe between the cheek and gum aiming towards the back of the mouth, slowly depress the plunger to administer the medication. If using an oral spray, remove the cap and direct the nozzle towards the inside of the cheek, press the spray button to deliver the required dose.
4. Dosage: the dosage of Buccal Midazolam should be determined based on an individual’s age, weight and/ or specific medical conditions. Follow the prescribed dosage instructions provided by the healthcare professional or as indicated in the manufacturers’ guidelines. It is important to administer the correct dosage to ensure its effectiveness and minimize the risk of adverse effects
5. Monitoring: after administering Buccal Midazolam, closely monitor the individual for any changes in their condition, including cessation or reduction of seizures. Observe for any adverse effects such as drowsiness, respiratory depression or allergic reactions. Continuously assess their vital signs which includes the heart rate, blood pressure and oxygen saturation if possible.
6. Documentation: it is crucial to accurately document the administration of Buccal Midazolam, including the date, time, dosage, route of administration and any observed effects or adverse reactions. This documentation is important for continuity of care, communication with other healthcare providers and for legal purposes.

What is to be monitored after the use of Buccal Midazolam?

• Seizure Activity
• Vital Signs
• Respiratory Function
• Consciousness and Sedation
• Adverse reactions

What are possible side effects of Midazolam?

1. Sedation and drowsiness
2. Respiratory Depression
3. Hypotension
4. Dizziness and Ataxia
5. Local irritation

What should be done in an emergency situation when Buccal Midazolam is needed?

Buccal Midazolam is often used in emergency situations to manage seizures, particularly in individuals who experiences prolonged or repeated seizures (status epilepticus). Here are some key points to consider in an emergency situation involving Buccal Midazolam:

• Recognize the emergency
• Call for help
• Administer Buccal Midazolam
• Monitor the individual
• Maintain a safe environment
• Communicate with Emergency Medical Services (EMS)
• Follow medical advice
• Document all details of the situation

Just a note:

Doing an online Buccal Midazolam Course with Train Healthcare, which takes approximately 1 hour to complete, will earn you 1 CPD Point. Once you have completed the course, you would receive a certificate thereof.