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
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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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