Distat. What Would You Do?

[lifelearningrn]

Hi wonderful school nurses. I have question about distat administration. If a student with a very generic seizure action plan (do not restrain child, admin distat (if ordered) for seizures lasting >5 minutes, call 911 for seizures lasting >5 minutes, etc.) has a simple partial seizure and refuses to allow anyone to touch her (to even have her lay down), during seizure at school, would you forcibly restrain the child (Kinder) to administer distat?

[nursedarrah]

In a pinch, Diastat can be put down a G-tube, if they have one. Of course you have to get a new order. Bucal or SL formulas are nice. I have heard of individuals who crushed up valium and snorted it because it worked faster and they didn't have to worry about chocking on it if they started to have another seizure. (Not exactly an approved route.) But EMT's squirt IV Narcan under the tongue all the time when no veins are left.) There is usually on out side the box answer they never teach in Nursing School.

[vampiregirl, BSN, RN]

Would an order for intrantranasal midazolam be an option? I've seen studies that have shown this to be as or more effective than distat, plus the method of administration is more "socially acceptable" compared to rectal administration.