For CPAP-related anxiety in adults, what is the dose and route of midazolam that may be given one time?

• A. 1 mg IV/IO/IM/IN may be administered one time.
• B. 2.5 mg IV/IO.
• C. 5 mg IM/IN.
• D. No benzodiazepines should be used.

Answer: (A)

Anxiety during CPAP can derail therapy, so a small, single dose of midazolam is used to provide just enough relief to help the patient tolerate CPAP without risking oversedation. The approved amount is 1 mg given one time, and it can be delivered by IV, IO, IM, or intranasal routes. The one-time limit keeps the risk of respiratory depression and airway compromise low while still offering rapid anxiety relief. The different routes offer flexibility: IV/IO for the fastest onset, or intranasal if IV access isn’t readily available. Using higher doses or giving multiple doses would significantly raise the risk of hypoventilation and other adverse effects, which is why those options aren’t allowed here. As with any sedative, closely monitor breathing, oxygenation, and vital signs, and be prepared to manage any airway or respiratory issues that may arise.