First10EM - By Justin Morgenster - May 18, 2020
"The paper
Arya R, Kothari H, Zhang Z, Han B, Horn PS, Glauser TA. Efficacy of nonvenous medications for acute convulsive seizures Neurology. 2015; 85(21):1859-1868. PMID: 26511448
Bottom line
Intramuscular midazolam is probably supported by better evidence than intranasal, is likely more reliable, and considering the patient can’t feel the injection, should be our first line agent if we don’t have an IV in status epilepticus."