Midazolam Infusion

Dilution guide

Indication

ICU sedation when propofol contraindicated; status epilepticus.

Preparation

50 mg in 50 mL NS (1 mg/mL).

Dilution

50 mg / 50 mL → 1 mg/mL

Rate

0.02–0.1 mg/kg/h titrated; bolus 1–5 mg.

Monitoring

  • Sedation depth (RASS)
  • BP
  • Accumulation in hepatic/renal failure

Common errors

  • Long infusions → accumulation → delayed wake-up
  • Underuse of daily sedation hold

Pearls

  • Associated with delirium — prefer propofol / dexmedetomidine if possible
WardRound

WardRound

Clinical Decisions in Seconds