Which routes are approved for diazepam administration in seizure management per the protocol?

• A. IM/IV/IO
• B. PO
• C. Inhalation
• D. Subcutaneous

Answer: (A)

Diazepam must reach the brain quickly to stop a seizure, and the routes chosen for prehospital use are the ones that deliver reliably fast effects. Intravenous, intramuscular, and intraosseous administration provide rapid and predictable onset, which is crucial when a patient is actively seizing. IV access offers the fastest onset and allows dose adjustments as needed; IM is practical when IV access is not immediately available; IO gives a reliable alternative when venous access is difficult, especially in a seizing patient. Oral administration is avoided because absorption is slow and unreliable during seizures and when the patient may aspirate or cannot safely swallow. Inhalation and subcutaneous routes do not provide the same reliability or speed of onset in this protocol. Therefore, IM, IV, and IO are the approved routes.