In a seizing patient, Midazolam can be given by standing orders via which routes?

• A. PO
• B. IM
• C. IN or IV
• D. Subcutaneous

Answer: (C)

Rapid control of a seizure depends on delivering midazolam quickly through routes that give fast, reliable onset without needing prolonged airway or IV setup. Oral is not suitable during a seizure because absorption is unreliable and there’s a higher aspiration risk. Intranasal midazolam provides rapid absorption through the nasal mucosa, is easy to administer, and avoids needing IV access. Intravenous administration delivers the medicine immediately and can be used when IV access is already available or easily obtained, allowing immediate effect and the option to titrate if needed. Other routes like subcutaneous or intramuscular are slower or less predictable in onset and aren’t preferred under this standing-orders framework. Hence, intranasal or intravenous routes are the appropriate options.