An alternative route of drug administration in acute convulsions.

Case Description A 20 kg 5-year-old boy was rushed by his parents to our adult trauma unit. They reported a history of a persistent grand mal seizure that had begun a half-hour earlier. Attempts at intravenous cannulation by the staff were unsuccessful. An anesthesiologist who happened to be examining another patient suggested the use of intranasally administered droplets of midazolam. Within 2 minutes of the 5 mg dose (concentration 5 mg/ml), the child stopped convulsing. An intravenous line was established, and the child was referred to our pediatric colleagues for further management.