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Information for the administration of Rectal Diazepam by parents & carers

What is Rectal Diazepam?

Diazepam is part of a group of drugs called Benzodiazepines. Diazepam is used rectally for a child or teenager who is experiencing prolonged or clusters of seizure, as it is a fast, effective method of control. The rectal preparation is available as Stesolid (yellow tube) or Diazepam Rectubes. The medication may be prescribed in rectal tubes as 2.5mg (in 1.25ml of liquid), 5mg (in 2.5ml), 10mg (in 2.5ml) or 20mg (in 5ml).

General Management of the Seizure

In the event of the child having a prolonged seizure the following steps should be taken:

  1. Make the child safe and note the time of when the seizure started.
  2. Make the child comfortable, preferably lying down on the floor or a bed (ease to floor if sitting). Do not move the person more than is necessary.
  3. Loosen any tight clothing, remove glasses and ensure there are no objects or furniture that could cause any harm.
  4. Ensure the airway is not obstructed, turn the child onto their side to allow vomit or phlegm to be expelled rather than inhaled. Do not place anything into the mouth or attempt to force the teeth apart. Do not attempt to restrict the convulsive movements.
  5. Call for assistance if someone else is present.

When to give Rectal Diazepam

  • A. If the seizure lasts for more than the agreed time (usually 5 minutes) then rectal diazepam should be used.
  • B. The dose to be given should be stated on the prescription for your child or on the emergency protocol if you are a carer. Ensure you check the dosage and expiry date

How to administer Rectal Diazepam

  1. Providing as much privacy as possible, turn the child onto their side with the knees drawn up if possible.
  2. A small child may be placed across the knees. Remove the tube cap.
  3. Insert the entire length of the nozzle gently into the bottom in a downward position (For children under 3 years of age insert only halfway to the ringed mark).
  4. Empty contents completely by squeezing firmly between index finger and thumb.
  5. When the tube is empty, keep squeezing tube and withdraw gently whilst attempting to keep the buttocks squeezed together for a few moments to prevent seepage. Throw the tube away.
  6. Providing they are safe and in a comfortable environment it is safer for them to recover on their side or the recovery position. Always ensure that someone stays with the child until fully recovered.
  7. If while giving rectal diazepam the child has diarrhoea, then stop and seek medical advice immediately by ringing 999.

What are the side effects?

Side effects are usually very mild, these may include:-

  • Drowsiness.
  • Light-headedness.
  • Unsteadiness.

Storage of Rectal Diazepam

The diazepam should be stored in a locked cupboard, safely out of reach of children. It needs to be stored below 25C but not in a fridge. Each individual tube of diazepam will be marked with an expiry date; this should always be checked before being given.

Any medicine that is out of date should not be used.

If at any time your child's condition gives cause for concern, medical help should be sought immediately whether or not rectal diazepam is administered.

Please contact the Epilepsy Nurse on 01803 655586 if you have any questions about the information in this leaflet.

Patient information prepared by Child Health Department © South Devon Healthcare NHS Foundation Trust, 01/03.

Date leaflet last updated: 06%2F04%2F2004

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