UNCONTROLLED WHEN PRINTED
Introduction

Compounded medication produced for pre-drawn use in maintaining sedation post RSI.

Morphine

  • A narcotic analgesic acting on CNS by binding with opioid receptors
  • Also combines to cause respiratory depression, vasodilation, decreases gag reflex and slows AV node conduction

Midazolam

  • A water-soluble benzodiazepine that has anxiolytic, sedative and anticonvulsive characteristics. This is due to its bonding with receptors in the CNS; its action to increase the inhibitory effect of the g-aminobutyric acid (GABA) neurotransmitter on the GABA receptors and subsequent membrane threshold.
  • Midazolam is lipid-soluble in physiological pH and it reaches the CNS quickly
Indications
  • Maintain sedation post RSI
Contraindications
  • Hypersensitivity
Precautions / Notes
  • Elderly patients
  • Hypotension
  • Patients on monoamine oxidase inhibitor
  • Renal failure
Management
Critical Care Paramedic only
  • Infusion Dose: 0.1-0.2mg/kg/hr IV/IO
  • Bolus Dose: 0.05-0.1mg/kg PRN
Special Considerations
  • Hypotension 

References
References
Presentation
  • 15mL pre-drawn syringe
  • 15mg Midazolam
  • 15mg Morphine

Concentration:

  • 1mg Midazolam & 1mg Morphine per 1mL of solution
Colour assist:

Discarding unused medication must be witnessed and countersigned by attendant and credible witness.

Document Control


Directorate
Clinical Services

Responsible Manager
Deputy Medical Director

Date of Issue

Date of Expiry

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