intranasal versed

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Specializes in school nursing, ortho, trauma.

I know this is the time of year that we all check out, so i am guess i'll have to resurrect this thread come fall, but this is cropping up now for me in the last 2 days of school (and for impending summer school).

I have a student with a complex seizure issue who will be returning to me on intranasal midazolam (versed). I don't have any experience with giving this medication in this manner in a school setting and wondered if anyone here did. What can I expect afterward? Is an immediate transport to a local after administration necessary? Will the drug cause sedation?

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I've never had to give it but I do know that if EMS is called & they need to use it they are required to transport to hospital.

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Specializes in Complex pedi to LTC/SA & now a manager.

It's similar to rectal Diastat. Not all require hospital transport, but this is spelled out in the seizure action plan. I have one PDN patient that is intra nasal midazolam is given for a seizure >5 min EMS is called.

A second patient seizure >5 min versed (total 5mg/nostril) if no response in 5 min Keppra via GT q5min x 2, if still seizing OR oxygen sat drops/significant change in VS then EMS is called.

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Specializes in school nursing, ortho, trauma.

Seizure action plan on my desk says to call EMS if a 2nd dose of medication is necessary... says i may repeat in 5 min if s/s do not stop. I am positive this student has gotten this medication at home (returning to school with a private duty nurse) and was most likely not transported to the ER after getting this medication, but there are different rules here.

I'm awaiting advice from district attorney, was just looking to see if any insight.

I do really appreciate the advice, Justbeachynurse, of using the pulseox... i think since they're selling them cheap enough i'll just look to get one to keep in her classroom.

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Specializes in Complex pedi to LTC/SA & now a manager.

My patient has pulse ox orders. I'm sure you can get a standing order for pulse ox from district MD. They are around $30 an intended for ~12y and older. Easily cleaned with an alcohol swab.

One school policy overrides our PDN orders in that if Diastat or midazolam is given for seizure >5 min EMS must be called. The other school follows MD signed seizure action plan.

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