Nasal seizure medication is a specialized rescue treatment prescribed for individuals prone to prolonged or clustered seizure activity. This medication is typically a fast-acting benzodiazepine, such as midazolam or diazepam, formulated for rapid absorption through the nasal lining. Its primary function is to quickly halt a seizure episode that has exceeded the patient’s pre-determined safe duration.
This route of administration offers a significant advantage because it bypasses the digestive system, allowing the medication to enter the bloodstream swiftly. This rapid action helps prevent status epilepticus, a medical crisis where a seizure lasts longer than five minutes or multiple seizures occur without recovery. It is an emergency intervention and not a substitute for a patient’s daily seizure control medicine.
Recognizing the Emergency and Preparation
The decision to administer this emergency medication is guided by the patient’s specific Seizure Action Plan (SAP). This plan, created by a healthcare provider, outlines the precise criteria for intervention, often targeting seizure clusters or acute repetitive seizures. These episodes are defined as seizures distinct from the patient’s usual pattern or those that continue past a specified time limit, often between two and five minutes.
Before administering the medication, the immediate safety of the patient is the priority. Gently move the patient into a safe, open area and position them on their side (the recovery position) to help maintain an open airway. Check the medication itself, confirming the name, dose, and expiration date match the prescribed treatment plan.
The pre-filled nasal spray device is a single-use unit designed for immediate deployment. Ensure the device is ready and in its sealed packaging, but never attempt to “test” or “prime” the spray before use. Doing so will cause the medication dose to be lost.
Step-by-Step Administration Guide
Begin by peeling open the blister packaging and carefully removing the nasal spray unit, taking care not to press the plunger prematurely. Hold the device securely with your thumb positioned on the bottom of the plunger, and your index and middle fingers resting on either side of the nozzle. This grip provides stability and leverage for quick administration.
Gently insert the tip of the nozzle into one of the patient’s nostrils until your fingers touch the bottom of the nose. This positioning ensures the spray is directed correctly into the nasal cavity for optimal absorption. The patient does not need to inhale deeply or change their breathing pattern for the medicine to work effectively.
Press the plunger firmly and completely with a single, smooth motion to deliver the entire dose into the nostril. This action atomizes the medication into a fine mist and delivers it quickly across the nasal membrane. Once the dose is delivered, remove the nozzle and discard the single-use spray unit.
If the Seizure Action Plan allows for a second dose, and the seizure continues after a specified waiting period (typically 10 minutes), a new spray unit must be used. Administer the second dose into the opposite nostril to maximize absorption. Always refer to the patient’s specific instructions regarding the timing and necessity of a second dose.
Monitoring and Follow-Up Care
After administering the nasal medication, remain calm and closely monitor the patient’s condition, noting the exact time the dose was given. The medication is designed to stop the seizure within minutes, marked by the cessation of convulsions and gradual relaxation of the patient’s body. The person will likely become very sleepy, which is an expected effect of the benzodiazepine.
Continued monitoring is necessary, particularly for signs of respiratory distress. Watch for shallow or slowed breathing, blue or gray discoloration of the lips or nail beds, or excessive sedation. These symptoms indicate a potential medical emergency that requires immediate intervention.
The protocol for calling emergency services (such as 911 or the local equivalent) must be followed if the seizure persists beyond the time specified in the Seizure Action Plan, even after the medication has been given. Emergency services should also be contacted immediately if the patient shows signs of breathing difficulty or unresponsiveness.
Once the seizure has ended, continue to keep the patient in the recovery position and allow them to rest. Document the exact time the seizure began, when the medication was administered, and the seizure duration for the treating healthcare provider.