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Buccal midazolam: is a test dose in hospital needed?
  1. D Hindley,
  2. H Jameson
  1. Bolton PCT, Halliwell Children’s Centre, Bolton BL1 3SQ, UK; dthindley@doctors.org.uk

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Midazolam has been given via the buccal route for the acute management of prolonged seizures for some years. Buccal administration is preferable to the rectal route for parents and carers.1 There is evidence that midazolam given in this way is more effective in curtailing seizures than diazepam and that there is no difference in the incidence of side effects.2

In some districts, including our own, if the family and the prescribing clinician want to use buccal midazolam the child is admitted as a day case to an acute paediatric ward for a “test dose”. This has a number of disadvantages, particularly for children with autism or complex …

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