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Managing Child with Convulsions

Give diazepam rectally

How to give diazepam (or paraldehyde) rectally for convulsions

Give diazepam rectally:

  • Draw up the dose from an ampoule of diazepam into a tuberculin (1 ml) syringe. Base the dose on the weight of the child, where possible. Then remove the needle.

  • Insert the syringe into the rectum 4 to 5 cm and inject the diazepam solution.

  • Hold buttocks together for a few minutes.

* Use phenobarbital (200 mg/ml solution) in a dose of 20 mg/kg to control convulsions in infants <2 weeks of age:


Weight 2 kg - initial dose: 0.2 ml, repeat 0.1 ml after 30 minutes (if convulsions continue)

Weight 3 kg - initial dose: 0.3 ml, repeat 0.15 ml after 30 minutes (if convulsions continue)

If convulsion continues after 10 minutes, give a second dose of diazepam

rectally (or give diazepam intravenously if IV infusion is running).


If convulsion continues after another 10 minutes, give a third dose of diazepam or give paraldehyde rectally (or phenobarbital IV or IM).


If high fever:


  • Sponge the child with room-temperature water to reduce the fever.

  • Do not give oral medication until the convulsion has been controlled(danger of aspiration).

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Last updated on 21.08.2020


  1. WHO. August 21.2020

  2. Tanzania Standard treatment guidline for pediatric, edition 2017

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