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A 2001 trial (JW Emerg Med Oct 4 2001) established the value of intravenous (IV) benzodiazepines for treatment of prolonged seizures in the prehospital setting, but prehospital personnel often use intramuscular (IM) midazolam for this purpose when they cannot establish IV access. Researchers compared the efficacy of the IM and IV routes in a randomized, double-blind noninferiority trial involving 33 emergency medical services systems.
Adults and children estimated to weigh >13 kg were enrolled if they were having convulsive seizures at the time of paramedic treatment and were reported to have been convulsing either continuously for ≥5 minutes or intermittently for ≥5 minutes without regaining consciousness. The researchers randomized 893 pat…