Hey everyone, welcome to Medication Monday. This is where we go over a different EMT drug that we administer out in the field. We do it specifically in EMT drug card format. As always, follow your local protocol and scope of practice.
Today's medication is called diazepam. Diazepam is most commonly known out in the EMS field as thallium. Thallium falls under the class of benzodiazepines.
Your mechanism of action, just like our other benzodiazepines that we've gone over, Versed and also Ativan, it interacts with the GABA receptors in the central nervous system and this causes anticonvulsant, hypnotic, sedative, anxiolytic, amnesic, and muscle relaxant effects. Your indications are going to be seizures or seizure-like activity, anxious patients or patients that are agitated or violent or suffering from some sort of behavioral emergency, also sedation for certain procedures. Before we get into the dosages of Valium, I just want to stress to abide by your local protocol and scope of practice because dosages do vary. Your dose is going to be 2 to 10 milligrams IV or IO or intramuscular. If you're giving it IV or IO, it needs to be a a very slow IV IO push.
Your pediatric dose is going to be 0.05 to 0.1 milligrams per kilogram. Your contraindications of Valium are going to be hypersensitivity, coma, head injury, severe central nervous system, or respiratory depression. Adverse reactions could include headache, pain at the injection site, phlebitis, tissue necrosis.
respiratory depression, CNS depression, hypotension, apnea, and cardiac or respiratory arrest. Okay, so going into some of the drug interactions of Valium. Valium can and will interact with other narcotics, other benzos, sedatives, hypnotics, and even alcohol, and it does it by increasing or potentiating the CNS depression and hypotension. How it's typically supplied, you definitely on the EMS field will see it in the 5 milligrams in 1 ml vial. A few side notes about Valium.
So Valium can be an irritant to the vein just like Versed is. So it's important to try and locate a larger, healthier vein and make sure you flush the IV line. Don't leave any excess medication in the IV line itself. And do not dilute this with other solutions.
Your onset of the medication is typically between 1 to 5 minutes. So it's pretty fast acting. It is recommended to reduce the dose by half for elderly patients.
And that kind of ties in with the next point, which is just to be aware of the risk of respiratory depression or respiratory arrest after administration. And that actually ties into the next point, which is just apnea in children after administration may occur. Really be aware of the fact that what you're giving, especially if they already have a central nervous system depressant on board, what you're giving is going to potentiate that.
And even if they don't, I'm... some people are very, very sensitive to CNS depressants, to benzos, narcotics, etc. So just be aware of this. As always, guys, please abide by your local protocol and scope of practice.
This is purely informational for those in the EMS field and never meant to be used in the place of local protocol or formal education. I will see you guys next Monday. Bye!