Medical Emergencies in the Dental Surgery Midazolam Buccal Liquid Use of medication

Medical Emergencies in the Dental Surgery
Midazolam Buccal Liquid
Use of medication

Midazolam Buccal Liquid, midazolam 5mg/ml for use in dental surgeries to help with the management of epileptic seizures. The medication comes in 2ml vials and should only be given if the seizures are prolonged (more than 5 mins) or repeated rapidly. The midazolam buccal liquid should be given by the buccal route in a single

2 ml dose containing 10mg for an adult patient

0.5ml dose containing 2.5mg for 6-11 months

1ml dose containing 5mg for 1-4years

1.5ml dose containing 7.5mg for 7-9 years

2ml 10mg dose conyaining 10mg for 10-17 years

Controlled Drug

Midazolam Buccal Liquid, midazolam 5mg /ml is a Schedule 3 controlled drug.

Midazolam Buccal Liquid does not need to be kept in a controlled drug cabinet and records of its use do not have to be kept in a controlled drug register
All dental surgeries with Midazolam Buccal Liquid midazolam are required to have a Standard Operating Procedure (SOP) to ensure that it is safely managed.

Standard Operating Procedure - Midazolam Buccal Liquid
Ordering

5x2ml vials of Midazolam Buccal Liquid, midazolam 5mg/ml, are supplied as part of the Tayside Pharmaceuticals Emergency Drug Kit.

The kit does not require to have the seal on the kit broken and be opened unless a medical emergency has occurred.
Storage in the Dental Surgery

Once delivered to the Dental Surgery the Midazolam Buccal Liquid, midazolam 10mg/ml, should be stored in the surgery in close proximity to the other essential emergency drugs.

In all surgeries and clinics the Midazolam Buccal Liquid, midazolam 5mg /ml, and the other essential emergency drugs must be stored in an easy to access location that is safe from the risk of loss or theft. Access to all emergency drugs in the dental surgery should be restricted to members of staff. Members of staff must ensure that patients or their carers or members of the public do not interfere with emergency drugs or equipment stored in the surgery.
However, while Midazolam Buccal Liquid, midazolam 5mg /ml, and the other essential emergency drugs are exempt from safe custody requirements it is good practice to store them as safely and securely as possible. In some sites the dental staff members have decided to store the Midazolam Buccal Liquid, midazolam 5mg/ml, in a different room in a locked cupboard overnight and then return it to the clinic or surgery first thing the next morning. In situations like this a simple system must be put in place to record the movement of the Midazolam Buccal Liquid, midazolam 5mg/ml, in and out of the overnight storage location. This must be carried out by a Qualified Dental Nurse or Dentist.
Checking Drugs

A weekly check of expiry dates for all emergency drugs, including Midazolam Buccal Liquid, midazolam 5mg /ml, must be carried out and a record of this kept.

If the Tayside Pharmaceuticals Emergency Drug Kit is sealed the daily check only needs to record that it has been checked and is sealed.
Each day a surgery or clinic is operational a check should be made of all emergency drugs, including Midazolam Buccal Liquid, midazolam 5mg /ml, to ensure that all items are present. A formal record of this check should be kept detailing dates, times and staff involved. Early identification of missing drugs will ensure a prompt response. If any emergency drug including Midazolam Buccal Liquid, midazolam 5mg /ml, is found to be missing the initial actions to take are:

• 
  Inform a Senior Member of staff
  
• 
  Carry out a thorough search of the area
  
• 
  Complete a RIDDOR form
  
• 
  Order a replacement item
  

If Midazolam Buccal Liquid, midazolam 5mg/ml, is found to be missing this must be reported to the Accountable Officer responsible for Controlled Drugs via the Controlled Drug Governance Team at [e-mail]. Tel [phone].

Written by: ……………………………
Date written: ……………………………………
Approved by: ……………………. (name and sig of responsible dentist)
Review date: ……………. (date + 2 years)