Epilepsy is a complex condition with many different types of seizures possible. Each individual responds differently to the condition and so it is not possible to provide specific risk management guidelines applicable to all children within a school. Each school therefore needs to develop a series of risk management plans that are suitable for individual children with epilepsy, i.e. each child will likely need to have a different plan. These plans may be developed in consultation with the child concerned, his/her family or carers, an epilepsy adviser, and an epilepsy specialist.
The welfare and safety of all children in a school are paramount and so a number of factors need to be considered in developing risk management plans for individuals with epilepsy.
Factors to be considered are:
Do you have sufficient information regarding the child’s type of epilepsy and seizure patterns?
Ask the family/carers to complete details using a child’s epilepsy information record’ form.
The school’s information form could include information on the following:
- the type of seizure and how it affects the child
- the frequency of the seizures (children or parents/carers need to keep a seizure diary)
- is the child newly diagnosed with epilepsy? In this case, an epilepsy specialist would have put in place a care plan; this care plan must be followed in the school’s risk management plan
- is there a change in medication or has it been stopped? These changes can cause so-calledbreak-through seizures, i.e. seizures that start suddenly after a seizure-free period
- what are the seizure triggers?
Create a risk management plan with the information that you have, in consultation with the
parent/carer, epilepsy specialist, and epilepsy adviser. See ‘Management plan for children’.
First Aid knowledge
– Are all staff trained in first aid and CPR?
– Have the staff been trained to recognize seizure types and know what to do when one occurs?
– Do staff members know what to do when convulsive seizures occur with a child in a wheelchair or in water?
– Are relief teachers informed about a child’s epilepsy condition and needs, and know how to take appropriate first aid action if necessary?
Do the staff know when a seizure becomes a medical emergency?
Staff must:
- follow the child’s risk management plan and follow the emergency steps
- have two or more staff trained to administer medication (rectal diazepam/buccal midazolam) if required
- take steps to maintain a child’s privacy and dignity whilst administering diazepam
- have someone phone 111 and ask for immediate help and state that the seizure is a medicalemergency
Are the staff aware of anti-epileptic medication?
- that medication is taken regularly as prescribed
- that all medication can cause possible side effects
- that many of these side effects can cause behavioural/emotional changes, hyperactivity,irritability, drowsiness, dizziness, tiredness, concentration difficulties, speech disturbances, depression, confusion
- that rectal diazepam or buccal midazolam should not be administered after its use-by-date has expired
- that all medication must be stored carefully and out of the reach of children
Are the staff aware that children with epilepsy may have:
- attention and concentration problems
- memory problems whereby storing, retrieving, and encoding information are difficult;
- children with epilepsy may even have problems following instructions
- difficulties understanding and interpreting information and therefore need more time to process it
- impaired reasoning which can affect relationships with friends/classmates, and the child’s ability to solve problems
- a fear of having a seizure in front of their peers because seizures are unpredictable
- experienced social stigma associated with their epilepsy
- developed poor self-esteem which, if left unchecked, can lead to depression
Are the other children prepared?
- have the children been given a lesson by your local epilepsy adviser on epilepsy?
- do the children know how to give first aid if necessary in the classroom/playground?
- are the children taught to be respectful of a child with epilepsy?
- does the class use a buddy system?