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    How physicians can guide seizure management in schools

    Seizures can be scary and dangerous, particularly in a school setting where medical help may not be immediately available. This is why every school district should have a plan in place to care for students with epilepsy, says the American Academy of Pediatrics (AAP).

    To help schools accomplish that task, AAP has released a recent set of guidelines covering everything from prescribing guidelines, rescue medications, and training.

    “Children with epilepsy warrant advance planning for medical emergencies in a school setting,” says Cindy Devore, MD, FAAP, chair of the AAP Council on School Health. “Collaboration among prescribing providers, families, and schools may be useful in developing individualized action plans for the use of seizure rescue medications in school.”

    Related: How to dispel the myths after the first seizure

    Nearly 1% of US children have epilepsy, and many of them attend traditional school programs. While some of these students’ may have their epilepsy well-controlled through medication, others are never able to fully control their condition. It is therefore important that school personnel know what types of interventions they can and should perform to end the seizure, or at least manage its duration to prevent prolonged recovery periods or additional injury, Devore says.

    Seizures that are prolonged may evolve into status epilepticus—a much more serious condition, says Devore. Rescue medications can halt the seizure and prevent the need for more extensive medical care, she says, but inconsistent laws across the country may limit what school staff is able to do in terms of first responder care. Physicians must be aware of their local laws and practices before prescribing a medication regimen for use in schools.

    Ideally, a school nurse is available to carry out medical orders from the child’s physician to manage seizures that take place in school, Devore says, but that is not always possible. School nurses may be able to create action plans based on the physician’s order for the school’s unlicensed assistive personnel (UAP) to use in the nurse’s absence. The UAPs can be trained by the nurse to carry out a series of steps depending on what is happening with the child.

    In some areas where the schools have no school nurse at all, it may be up to the physician to create an action plan and train staff members. In such cases, physicians have the option of creating a plan specific to the student, or modifying a generic plan from a template.

    NEXT: What else should action plans contain?

    Rachael Zimlich, RN
    Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare ...


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