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Midazolam use in the emergency department
E A Ramoska1, R Linkenheimer, C Glasgow
1Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
The Journal of Emergency Medicine
|July 1, 1991
Summary
Midazolam, a potent and fast-acting sedative, proved safe for emergency department use in a retrospective study. This imidazobenzodiazepine derivative demonstrated minimal adverse effects in 120 patients, supporting its utility for outpatient sedation.
Area of Science:
- Pharmacology
- Emergency Medicine
- Sedation Therapeutics
Background:
- Midazolam is an imidazobenzodiazepine derivative with high potency, water solubility, rapid onset, short duration, and amnestic effects.
- These characteristics suggest its utility for outpatient sedation, particularly in emergency settings.
Purpose of the Study:
- To evaluate the safety and efficacy of midazolam for sedation in a general emergency department.
- To document adverse reactions and patient outcomes associated with midazolam administration.
Main Methods:
- Retrospective review of midazolam usage over a one-year period in a general emergency department.
- Data collected on patient demographics, dosage, co-administered medications, and adverse events.
Main Results:
- Midazolam was administered to 120 patients (average age 46 years) with an average dose of 3.4 mg (range 1-10 mg).
- Concomitant medications were given in 57% of cases, most frequently opiates.
- Only four adverse reactions were reported: urinary retention (1), vomiting (1), and prolonged somnolence (2). No serious cardiovascular or respiratory events occurred.
Conclusions:
- Midazolam is a safe and effective agent for sedation in the emergency department setting.
- Close patient monitoring and readily available airway support equipment are essential when administering midazolam.