Emergency Plan For Giving Buccal Midazolam For A Seizure

The illustration is a flowchart titled What to do if your child is having a seizure. 

Text at the top reads: Give midazolam if the seizure lasts over 5 minutes or if ___ seizures happen within ___ minutes.

• On the left side, a black vertical bar marks the timeline: 0 minutes, 4 minutes, 5 minutes.
• At 0 minutes, a box reads: Seizure starts. Inside are the steps: Start timing the seizure, stay calm, move your child to a safe place, reassure your child. In bold, it adds: Video the seizure if possible.
• A green arrow labelled Continues points down to 4 minutes: A hand draws liquid into a syringe. Text reads: Draw up ____ ml of midazolam (15mg/3ml).
• A green arrow labelled Continues points down to 5 minutes: A child is shown receiving medicine into the side of the cheek. Text reads: Give midazolam into the side of the cheek (buccally). Below it says: Call 111 unless instructed otherwise by your doctor.
• A navy blue line labelled Stops comes from each of the boxes at 0 minutes, 4 minutes and 5 minutes. They all point to the right-hand side box. Text reads: Put your child in the recovery position. A child lies on their side with text labels: Head tilted to keep airway open. Hands support head. Mouth is toward the ground. Knee stops body from rolling.
• Below this, a yellow box reads: Let child rest & recover. Stay with them until back to normal. Record in seizure diary. If advised, let medical team know. Dr ______.

At the bottom of the illustration is a green box with a QR code and text:
'For more detailed information, see Seizure First Aid on KidsHealth by scanning the QR code or visiting www.kidshealth.org.nz/seizure-first-aid'

At the bottom left is the KidsHealth logo with the website: kidshealth.org.nz.

The illustration is a seizure first aid plan titled What to do if your child is having a seizure. 

At the top, a teal box reads: Give midazolam if the seizure lasts over 5 minutes or if ____ seizures happen within ____ minutes.

Ten numbered steps are listed:

1. Stay calm and reassure your child.
2. Make sure your child is in a safe place. If not, lay them down on the floor, or move furniture or sharp objects.
3. Start timing the seizure. Video the seizure if possible.
4. At 4 minutes of seizure activity prepare the midazolam (15mg/3ml) = ____ml. An illustration shows two hands preparing midazolam in a syringe.
5. At 5 minutes of seizure activity give midazolam into the side of the cheek (buccally). An illustration shows the medicine being given inside a child’s cheek with a syringe.
6. Call 111 for an ambulance when you give the midazolam, unless instructed otherwise by your doctor.
7. Watch your child’s breathing.
8. When the seizure has finished place your child in the recovery position. An illustration shows a child lying on their side with labels: Head tilted to keep airway open, Hands support head, mouth is toward the ground, Knee stops body from rolling.
9. Let your child rest and recover in a calm and quiet space until back to normal.
10. Document the seizure in a seizure diary. If instructed, let your medical team know about the seizure.

At the bottom of the illustration is a green box with a QR code and text:
'For more detailed information, see Seizure First Aid on KidsHealth by scanning the QR code or visiting www.kidshealth.org.nz/seizure-first-aid'

At the bottom left is the KidsHealth logo with the website: kidshealth.org.nz.