Sedation, analgesia and paralysis
Midazolam (Versed) drip
Versed
Dosing
| Start | 1–2 mg/h (0.02–0.1 mg/kg/h) |
|---|---|
| Titrate | By 25–50%, with boluses |
| Maximum | Usually up to about 10 mg/h; status epilepticus uses more |
| Common bags | 100 mg in 100 mL (1 mg/mL); 50 mg in 50 mL (1 mg/mL) |
| Dose units | mg/h, mg/kg/h |
Line and administration
- Peripheral or central
Watch for
- Builds up in kidney failure, obesity and older adults
- Linked to delirium; not first choice for ICU sedation (PADIS)
Midazolam: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Behavioral Emergencies, Agitation and AbuseSedation by cause (NASEMSO doses, BETA choice): Stimulants, withdrawal, unknown without psychosis: Benzodiazepine: Midazolam 5 mg IM (10-15 min) or IN; lorazepam 4 mg IM
- Medical Emergencies: Neuro, Endocrine, Blood and InfectionEvery call: Glucose in anyone altered, seizing or stroke-like; 60 mg/dL or less: D10 in increments (adult max 25 g; child 5-10 mL/kg) or glucagon 1 mg. Seizure on arrival or over 5 min: midazolam 0.2 mg/kg IM/IN (max 10 mg). Basics: emt-by-complaint; sepsis: prehospital-sepsis.
- Pediatric Assessment and EmergenciesFebrile seizures and dehydration: Over 5 min or seizing on arrival: airway, O₂, glucose, benzodiazepine (paramedic: midazolam 0.2 mg/kg IM/IN, max 10 mg, per protocol)
- Airway and RSIRSI drugs: Midazolam: 0.15–0.35 mg/kg: 1.5–2.5 min: Slow onset; hypotension
- Neuro: ICP and StrokeStatus epilepticus: No IV: Midazolam 10 mg IM
- Pediatric Vital Signs and Drug Doses for EMSCommon prehospital pediatric doses: Midazolam: Active seizure: 0.2 mg/kg IM or IN; 0.1 mg/kg IV/IO: 10 mg IM/IN; 4 mg IV
Practice Behavioral Emergencies, Agitation and Abuse questions free25 exam-style questions with rationales on the topic where midazolam comes up most. No account or download needed.
Other sedation, analgesia and paralysis
- Propofol
- Dexmedetomidine
- Fentanyl
- Cisatracurium
- Ketamine
- Hydromorphone
- Rocuronium
- Vecuronium
- Pentobarbital
- Remifentanil
Practice free in your browser2,450+ exam-style questions with rationales. No account, no ads. Also free on the App Store and Google Play.
For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.