#midazolam nonsense doing the rounds again. So here are some facts
“Midazolam shouldn’t be given to respiratory illness patients because it’s a respiratory depressant - it killed people” or some version of that is normally the tweet. We’ll look at why it’s a misunderstanding
“Midazolam shouldn’t be given to respiratory illness patients because it’s a respiratory depressant - it killed people” or some version of that is normally the tweet. We’ll look at why it’s a misunderstanding
Midazolam as a procedural drug:
Midazolam is used for procedures like endoscopy as sedation, in this scenario there are lots of medical people present, oxygen and ventilation equipment available, and a reversal agent flumazenil in the event a patients breathing is suppressed
Midazolam is used for procedures like endoscopy as sedation, in this scenario there are lots of medical people present, oxygen and ventilation equipment available, and a reversal agent flumazenil in the event a patients breathing is suppressed
Midazolam in critical care:
In this instance patients are ventilated, and midazolam is used as sedation. Contrary to popular belief people on ventilators aren’t all unconscious, but a ventilator is hard to tolerate entirely awake.
In this instance patients are ventilated, and midazolam is used as sedation. Contrary to popular belief people on ventilators aren’t all unconscious, but a ventilator is hard to tolerate entirely awake.
Midazolam may be used with or without other anaesthetic drugs. In this instance respiratory depression is less of a concern as breathing is mechanically supported. The pandemic increased this group of patients significantly.
Midazolam in palliative care:
Dying can be an uncomfortable process. Patients can be in pain, agitated, and producing lots of secretions. A combination of drugs are given to reduce distress from these things. They are given incrementally and often using a syringe driver
Dying can be an uncomfortable process. Patients can be in pain, agitated, and producing lots of secretions. A combination of drugs are given to reduce distress from these things. They are given incrementally and often using a syringe driver
A syringe driver delivers continuous low dose medicine so patients aren’t constantly disturbed. Patients on palliative pathways are dying, midazolam ensues dying patients don’t suffer, it doesn’t kill them. Respiratory depression is somewhat irrelevant because they are dying
Without palliative care drugs you might live longer, a few hours, in agony and distress. There were significantly more dying people in the pandemic. My guess is palliative care protocol wasn’t activated often enough, rather than too often, because of staffing & equipment pressure
So when you see the # #letstalkaboutmidazolam or #midazolammatt then yes, let’s talk about death and dying, and palliative care, the horror of dying without palliative care nurses and drugs, and the profound misunderstandings of non medics on the subject. #PalliativeCare
I’ll add James’ thread to mine too! @JamesLynchGTC
https://twitter.com/JamesLynchGTC/status/1585982189304422405
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