versed protocols in the field

[emtintraining31]

Thank you everyone for your replies, and I am certain that it was 30 of versed, I spoke directly with one of the paramedics who took care of her.

[danielir]

for an adult in stat-ep in nyc, on standing orders, we can give up to 4 of Ativan -OR- 10 of Valium -OR- 10 of Versed.

The protocols state, that after contacting OLMC, you can repeat the 10 of versed, for a total of 20, but thats not to say you can't get a discretionary order for whatever the doc feels like giving you. The highest dose I have ever heard of was 25.

As far as dosages of benzos given in the er, im no md, but im pretty sure they can give whatever the hell they want, as long as they can justify due regard for the patient. That medical license gives them the power to prescribe, where as we have more rigid protocols telling us what we can and cant do.

[AZCEP]

The maximum recommended loading dose for BZD's is 20 mgs. Any more than that at one time will not give any more of an effect.

If a patient needs more medication to control a seizure, consideration should be given to something other than the BZD.

[fireflymedic]

point well taken AZ - it is proven that if 20 mg of a benzo (either versed or valium) fails to bring a seizure under control that additional measures are probably going to be needed to abate the seizure. One thing we need to be sure of though pushing benzos to patients is that what they are experiencing is truly seizures, there are those out there that are pseudos (not consciously faking, but experience seizure like episodes which aren't). I've seen people go as far as DAI (drug assisted intubation as we don't have full RSI protocols except with 2 als providers) with them to only find out they didn't really have seizures. Better to error on side of caution true and overtreat, but good basic treatment, especially if they remain uncontrolled, exceeds any further ALS treatment unless you KNOW for sure (ie have dealt with patient many times, patient is well known as most of your poorly controlled are). Just something to think about.....

[paramedicmike]

Call me a cynic but the original post seems to be fishing for more than just what other's protocols are with regards to versed admin.

Just sounds a little fishy.

-be safe

[firefighter523]

I would not advise giving too much versed in the field, you risk the chance of causing undue chest rigidity. You will just make a sick pt sicker, more so will end up bagging your pt. We are only to give up to 5mgs IV versed, up to 10mgs IV valium, or up to 4 mgs IV, of Mag if the pt is suspected to be eclamptic. Believe it or not Narcan has worked for me to stop seizures after all else failed, it was pretty cool.

[tanman70@hotmail.com]

In the system that I run in we carry only 20mg of versed between our first in bag and cabbage case/when we RSI we can give a total of 10mg and for seizures max is 5mg/and going I.M that takes for ever why they did not try the M.A.D device is beyond me the nose and all the capillaries the drug would have hit the system alot faster but maybe the M.A.D was not available or is not in there protcol but it is a handy little device

Ativan I believe would have been best for the situation,but I do not know there protcol and like I tell many people it is very easy to sit here and arm-chair there call I was'nt there and have no idea what they were expericing with this patient/but as long as they did not make any med errors and followed there protcol they did the best that they could and at times in the field that is all we can do

[CBEMT]

2.5-5mg, repeatable x2 after 5-15 minutes, or to a total of 10mg

Supposedly our next protocol update will place Versed as our primary seizure med, instead of Valium which will be coming out. I haven't seen the draft, but from what I understand, Versed works better in seizures induced by certain WMD , and WMD are the bulk of the new updates. so.....

[p3medic]

Chest rigidity? I think you might be confusing versed with fentanyl.