I disagree that you need "slam dunk doses" of IM midazolam for seizures. Our
standard dose is 0.2 mg/kg to a max of 7 mg. No signficant respiratory
depression occurs and it is very effective in stopping seizures.
Chamberlain JM, Altieri MA, Futterman C, Young GM, Waisman Y. A Randomized,
Controlled Trial Comparing Intramuscular Midazolam with Intravenous Diazepam
for the Treatment of Seizures in Children. Pediatr Emerg Care 1997;13:92-4.
<<Midazolam is a drug that needs to be titrated IV for effective deep
IM midazolam is really used only for seizures and is given in high enough
doses (i.e. slam dunk doses) to assure a likely ED 50 but also puts it
closer to the LD50 (dose that would cause death in 50%). This is different
than using lower doses and titrating for procedures (higher risk/benefit
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