Buccal midazolam end of course assessment

Q1 True or false: Everyone with epilepsy is prescribed buccal midazolam.

True
False

Q2 For what types of seizures is buccal midazolam prescribed?

You can select more than one option.

Only tonic-clonic seizures
It’s most commonly prescribed for tonic-clonic seizures over 5 minutes
It may be prescribed for many different types of prolonged seizures
All seizures

Q3 What is the buccal cavity?

The space between the front lips and teeth
The space under the tongue
The space between the inner cheek and gum
The back of the throat

Q4 Which of the following should you check before administering buccal midazolam?

You can select more than one option.

The medicine has the person’s name on it
The dose stated in their care plan
Whether they took their daily epilepsy medicine that morning
That they have eaten before you administer buccal midazolam
That they have not already had the maximum dose of buccal midazolam in a 24 hour period, as stated in their care plan

Q5 When should you not use a person’s buccal midazolam medicine?

You can select more than one option.

When the expiry date has passed
When it’s cloudy or there are visible particles present
If the tamper seal is broken
If the care plan has passed its review date

Q6 The arrow is pointing to where you should aim the syringe to administer buccal midazolam.

Is this correct?

No
Yes

Q7 True or false: 1 ml of Epistatus and 1ml of Buccolam contain the same amount of buccal midazolam.

True
False

Q8 Watch this video of buccal midazolam being administered.

Is buccal midazolam being administered into the correct part of the mouth?

Yes
No

Q9 What are the potential difficulties in administering buccal midazolam?

You can select more than one option.

The person’s position
The person tells you they’re feeling fine and don’t want buccal midazolam right now
There is a lot of saliva
There is bleeding from the mouth

Q10 You are administering buccal midazolam but the person’s position is making it difficult to put the syringe in the other cheek.

What should you do?

Keep trying to get the medicine in the other cheek
Give the medicine all in the cheek you can access, but give it more slowly
Get it anywhere in the mouth, as it long as it goes in

Q11 Which of these are common side effects of buccal midazolam?

You can select more than one option.

Feeling sick or vomiting
Feeling itchy
Breathing difficulties
Excess saliva
Feeling drowsy or sleepy

Q12 In what circumstances should you administer a second dose of buccal midazolam?

Always give a second dose if the seizure hasn’t stopped within 5 minutes of giving buccal midazolam
Only when the person’s care plan says to
A second dose is never prescribed in the community

Q13 The person’s position is making it difficult to get to the buccal cavity. What should you do?

You can select more than one option.

Gently tilt the person’s head, without force, to access the other cheek
Move them to a different position if it’s safe to without causing injury to you or them
Put the medicine anywhere in their mouth, as it will still work
Call an ambulance if you can’t get to the buccal cavity

Q14 At what temperature should buccal midazolam should be stored?

Click and drag the items below to the correct place.

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At room temperature, but not above 25c
In the fridge

Q15 Click and drag to match these statements to the correct answer:

Sort elements

Always
Only if it says to in the care plan
Never
Tell the person’s healthcare team

An ambulance should be called the first time a person is given buccal midazolam

Give a second dose

Administer buccal midazolam that has passed it’s expiry date

If the care plan is past its review date

Q16 You are re-stocking the medicine cabinet and you notice that someone’s buccal midazolam medicine has gone cloudy.

What should you do?

Put it in the back of your car to drop off at the pharmacy when you’re passing by
Wash it down the sink
Follow your organisation’s policy for returning out-of-date medicines to the pharmacy
Keep it until a new supply of buccal midazolam is received from the pharmacy as using this will be better than having no medicine at all

Q17 Which of these should you do after administering buccal midazolam?

You can select more than one option.

Monitor the person’s breathing and look for signs of difficulties
Record the seizure and that you’ve given the medicine, following your organisation’s procedures
Keep timing the seizure until it stops
Securely store any remaining medicine
Throw the used syringe in the recycling

Q18 In which of these circumstances should you call an ambulance after administering buccal midazolam?

You can select more than one option.

The person’s lips are going blue and their breathing is shallow
The seizure hasn’t stopped after the amount of time stated in the person’s care plan
You are concerned the person needs urgent medical attention for any reason
You’ve accidentally given too much medicine
Their face is swelling up and you think they are having an allergic reaction to the medicine

Q19 True or false: Buccal midazolam is a schedule 3 controlled drug, but it _______ be stored in a controlled drugs cupboard.

Type in the correct word or phrase.

must | should | does not have to | cannot

Q20 Click and drag these steps into the correct order for administering buccal midazolam.

Monitor the person until the seizure has stopped and the person has recovered
Get what you need: medicine, gloves, care plan
Check the instructions in the care plan
Start timing the seizure
Give the medicine

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