Ativan 0.1mg/kg IV @ 2mg/min IV up to 10mg IV is benzodiazepine of choice
-Ativan preferred over Valium, as has longer effect
-May give Versed 5mg IM if no IV access
-If this is ineffective then:
Phenytoin (Dilantin) 10-15mg/kg IV @ 50mg/min (25mg/min in cardiac pt and 1mg/kg/min
peds)
-pH of 13 may cause big problems if extravasates, give slowly and must be diluted
-Must give while pt on monitors (may prolong QRS)
Fosphenytoin (Cerebyx) 15-20 mg PE/kg IV @ 150mg/min
-Use when have no IV access to give phenytoin
-Used instead of phenytoin as can be administered more rapidly as no propylene glycol
-May give up to 30cc IM as is water soluble
-May repeat up to 30mg/kg max dose
-If either phenytoin or fosphenytoin ineffective then:
Phenobarbital 20mg/kg @ 100mg/min
-May repeat up to 30mg/kg
-May cause hypotension and depressed respirations