It has been hypothesized that better distribution of midazolam on mucosal surfaces would improve the reliability and effectiveness of this route of administration. A device called an atomizer has been developed for just this purpose (Wolfe Tory Medical, Inc., Salt Lake City, UT). The atomizer is an attachment on the end of a small syringe that causes the medication to be propelled over a larger surface area in a spray (see Figure below). This allows a greater percentage of the medication to be absorbed via the mucosal surface with a direct route to the blood stream leading to faster and more reliable onset of action, while avoiding the problem of hepatic metabolism that occurs with enterally absorbed midazolam.