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Buccal Midazolam

Guidelines for the Administration of Buccal Midazolam. Buccal Midazolam is a treatment for convulsions, and it is administered orally

Buccal Midazolam can only be administered by a member of the staff who has volunteered and has been designated as appropriate by the head teacher/provider and who has been assessed as competent by the named school nurse. Training of designated staff will be provided by an appropriate medical professional and a record of the training undertaken will be kept by the head teacher/provider. Training will be updated at least once annually.

The prescription and consent form should reflect the specific requirements of each case and advice should be sought from specialist nurses/Consultant/GP.

  1. Buccal Midazolam can only be administered in accordance with an up-to-date written prescription sheet from a medical practitioner and the signed consent form. It is the responsibility of the parent/carer if the dose changes, to also obtain a new prescription sheet from the GP. The old prescription sheet should then be filed in the child’s records.
  2. The prescription sheet and Care Plan should be renewed yearly. The school nurse/health visitor will check with the parent/carer that the dose remains the same.
  3. The consent form, prescription sheet and Care Plan must be available each time the Buccal Midazolam is administered; if practical it should be kept with the Buccal Midazolam.
  4. Buccal Midazolam can only be administered by designated staff who have received training from an appropriate medical professional . A list of appropriately trained staff will be kept.
  5. The consent form, prescription sheet and Care Plan must always be checked before the Buccal Midazolam is administered.
  6. It is recommended that the administration is witnessed by a second adult.
  7. The child should not be left alone until fully conscious.
  8. The amount of Buccal Midazolam that is administered must be recorded on the child’s Buccal Midazolam record card. The record card must be signed with a full signature of the person who has administered the Buccal Midazolam, dated and parents/carers informed if the dose has been given in an emergency situation.
  9. Each dose of Buccal Midazolam must be labelled with the individual child’s name and stored in a locked cupboard, yet readily available. The keys should be readily available to all designated staff.
  10. School/setting staff must check expiry dates of Buccal Midazolam each term. In special schools the school nurse / doctor may carry out this responsibility. It should be replaced by the parent/carer at the request of school/setting or health staff.
  11. All staff who are designated to administer Buccal Midazolam should have access to a list of children who may require emergency Buccal Midazolam. The list should be updated at least yearly, and amended at other times as necessary.