Guidance on the usage of midazolam and other anaesthetic drugs has been modified to meet the pressures of the COVID-19 pandemic, highlighting the large quantities of the drugs being used to treat critically ill Covid patients.
The Royal College of Anaesthetists released guidance on “potential changes to anaesthetic drug usage and administration during pandemic emergency pressures” on 2 April 2020, stating that the demand for drugs such as midazolam to treat Covid patients has increased significantly.
Midazolam is labelled as a “first-line” sedative to treat critically ill COVID-19 patients, yet the dangers of the drug include potentially causing breathing difficulties or even halting breathing altogether. UK regulators state that midazolam can only be used in hospitals that have the equipment to monitor heart and lungs and to provide life-saving medical treatment.
Those who are treated with midazolam must have their vitals monitored closely by nurses and doctors to ensure that they are breathing properly as the drug can induce significant depression of respiration.
The drug is often used before minor surgery to relieve anxiety and induce drowsiness but can be used to put a patient in a state of unconsciousness. As stated previously, it is now being used as a primary treatment for critically ill COVID-19 patients, however, why would you treat a patient with a respiratory illness with a drug that has the potential to stop breathing altogether?
The guidance from the Royal College of Anaesthetists shows that midazolam and propofol are the primary drugs used for sedation and transfer, with midazolam being highlighted as a drug “which may be subject to demand pressure.” Midazolam has also been labeled as a drug which supplies have been retained “for use in critical care at times of increased demand during the COVID-19 crisis.”