Diazepam administration

Q&A: A query has been raised about the diazepam guideline in the 2017 Supplementary Guidelines. This has been updated in the 2017 Guidelines, especially with regards to titrate. The 2017 guideline on diazepam states that for convulsions: ‘The full dose should be given at the appropriate times. It is not appropriate to either i) gradually ‘titrate the dose upwards’ or ii) to only give a partial dose if the convulsion stops (once started, even if the convulsion stops, that dose must be given). If this approach is followed, convulsion recurrence is much less likely.’ The guideline also states that: ‘Route: Intravenous/intraosseous – administer SLOWLY over 2 minutes for adults (3–5 minutes for children). For convulsions give the full dose. In symptomatic cocaine toxicity titrate slowly to response.’