For a seizure in a child, which route is used for midazolam administration in prehospital care?

• A. Intranasal
• B. Intravenous
• C. Oral
• D. Intramuscular

Answer: (A)

In prehospital pediatric seizures, delivering a benzodiazepine in a noninvasive, rapid-acting way is essential. Intranasal midazolam fits that need because the nasal mucosa allows quick absorption, producing a rapid onset without the need to secure IV access. This is particularly important when a child is actively seizing and is difficult to cannulate, reducing the time to seizure control and avoiding the pain and distress of injections.

Oral administration is unreliable during a seizure due to risk of aspiration and unpredictable absorption. Intravenous access, while effective, can be hard to obtain in the field during an active seizure. Intramuscular administration can work but involves a painful injection and can have slower onset or variable absorption compared with intranasal delivery. Therefore intranasal midazolam is favored for the prehospital management of seizures in children.