Epilepsy Policy 2022

Epilepsy Policy

 

Policy Statement

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Play Inclusion Project recognises that Epilepsy is a common condition effecting children and young people and welcomes children and young people with Epilepsy to attend the Activity Clubs and weekly groups. This policy supplements the ‘Administration of Medication and Care of Sick Children’ and ‘Health and Safety’ policies.

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Play Inclusion Project has a responsibility to safeguard all children and young people who attend our activities.  If a child has epilepsy, this should be detailed in their individual care plan and medication form.  Activity Coordinators should also have a copy of the child’s individual epilepsy plan completed by their personal epilepsy nurse/parent/carer.  This policy ensures appropriate staff, receive relevant training about Epilepsy.

 

Record Keeping

 

Details of a child’s epilepsy will be recorded in their individual care plan.  Details recorded will include the types of seizures the child experiences, how the seizure presents, warning signs, triggers and the normal length of time for a seizure.  

 

Details of medications taken will be recorded on the child’s medication form. 

 

Types of Seizures

 

Tonic – Colonic seizure

 

Children who have tonic-clonic seizures (previously known as grand-mal) lose consciousness and fall to the ground. Their body goes stiff and their limbs jerk, irregular breathing can cause blueness of the lips and the individual may lose control of their bladder/bowels. When their seizure is over, their consciousness returns, but they may be very confused and tired. It’s important that you stay with them at this point whilst they recover.

 

First Aid for tonic-clonic seizures

 

First aid for the pupil’s seizure type will be included on their individual health plan and Activity Coordinators will receive basic training on administering first aid. 

 

The following first aid procedure is for tonic-clonic seizures 

 

• Stay calm. 

• If the child is convulsing, put something soft under their head. 

• Protect the child from injury (remove harmful objects from nearby). 

• NEVER try and put anything in their mouth or between their teeth. 

• Try and time how long the seizure lasts – if it lasts longer than usual for that child or continues for more than five minutes then call medical assistance. 

• When the child finishes their seizure stay with them and reassure them. 

• Do not try and move the child unless they are in danger. 

• Do not try and restrain the child. 

• Do not give them food or drink until they have fully recovered from the seizure. 

• Aid breathing by gently placing the child in the recovery position once the seizure has finished. 

 

Sometimes a child may become incontinent during their seizure. If this happens, try and put a blanket around them when their seizure is finished to avoid potential embarrassment

 

Absence seizure

 

During an absence seizure the child will briefly lose consciousness but will not lose muscle tone or collapse.  They will appear to be daydreaming or distracted for a few seconds.  While these episodes may seem unimportant, they can happen hundreds of times a day. This can cause the child to become confused about what is happening around them.  Generally, no first aid is needed for these seizures.

 

Complex partial seizures 

 

This type of seizure can be difficult to recognise. The child’s consciousness level will be affected to some extent, and they will not be fully in touch with what is happening around them. During the seizure they may do things repeatedly, such as swallowing, scratching or looking for something. Complex partial seizures can be misinterpreted as bad behaviour. In fact, the child will not know what has happened and will not remember what they were doing before the seizure started.

 

Although there is no real first aid needed for complex partial seizures, it’s important not to restrain the young person unless they are in immediate danger. This is because they may not recognise you and become frightened. However, if the child is walking towards a busy road, you should try to guide them to safety. When the seizure ends the child is likely to be confused, so it is vital to stay with them and reassure them.

 

Myoclonic seizures 

 

When a child has a myoclonic seizure the muscles of any part of their body jerks. These jerks are common in one or both arms and can be a single movement or the jerking may continue for a period of time. Myoclonic seizures happen most often in the morning, and teachers need to bear in mind that a child may be tired or lack concentration if they start school after having one of these. There is no first aid needed for myoclonic seizures unless the child has been injured, when usual first aid procedures are used. If the child is distressed by the seizure, they may need comforting and generally reassuring. 

 

Atonic seizures 

 

Atonic seizures cause a child to lose muscle tone. When this happens the child falls to the ground without warning. This can result in injuries to the face and head. Children who have regular atonic seizures may need to wear protective headgear to avoid injuries. There is no first aid needed for atonic seizures, unless the child is injured during the fall. 

 

General seizure advice 

 

Tonic-clonic seizures are the most widely recognised type of epileptic seizure. It’s important to note that most children need a rest following this kind of seizure. Depending on how they are feeling, they may be able to return to the session. However, if they take many hours to recover, they may need to be sent home.

 

Medication

 

The majority of children with epilepsy take anti-epileptic drugs (AEDs) to control their seizures. These drugs are usually taken twice a day, at home. This means there should be no issues about storing or administrating medicines during activities. The only time medicine may be urgently needed by a child with epilepsy is when their seizures fail to stop after the usual time or the child goes into status epilepticus. Status epilepticus is defined as a prolonged seizure or a series of seizures without regaining consciousness in between. This is a medical emergency and is potentially life threatening. If this happens, emergency medication needs to be administered by a trained member of staff. If this isn’t possible an ambulance should be called.

 

Rescue Medication

 

In the event a child requires rescue medication to stop a seizure, the Activity Coordiantor will follow the details contained in the child’s care plan and time the length of the seizure.  

 

Play Inclusion Project staff have been trained to administer Buccal Midazolam.  The medication will be administered into the buccal cavity and rubbed in through the cheek, with half being administered on one side of the mouth and half on the other.  

 

If a child or young person is having a seizure, rescue medication will be administered at 5 minutes and an ambulance will be called.  

 

As with all medication the child’s name must be on the box/packaging and the paper seal must not be broken.  The above procedure for administering medication will be followed.

 

NO MEDICATION WILL BE ADMINISTERED WITHOUT THE PRIOR WRITTEN

CONSENT OF PARENTS/CARERS

 

When to call Emergency Services

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Emergency services must be called if:

• It is the child's first seizure

• It states in the child's individual care plan that emergency services must be called

• The seizure lasts a total of 5 minutes without coming out of it

• The seizure is 3 minutes longer than normal pattern on the child plan

• The child is injured

• The child's breathing is severely impaired

• The child does not regain consciousness

• Further seizures occur without a child regaining consciousness