Seizure Disorders
Albemarle County Public
Schools
What is a Seizure?
An event in which there is a temporary change in
behavior resulting from a sudden, abnormal
burst of electrical activity in the brain or change
in the normal brain waves.
Generalized seizure: occurs when the disturbance
affects the entire brain.
Partial seizure: occurs when the disturbance
affects only one area of the brain.
Generalized Seizures: Tonic-Clonic
Usually lasts 2 – 3 minutes
May have aura or warning before
Eyes roll upward
Loss of consciousness and falls to ground
Becomes rigid as the muscles tighten
Followed by jerking movements of the entire
body as muscles undergo rhythmic tightening
and relaxing
 May become incontinent, breathing may be
shallow or stop briefly, person is usually drowsy
afterwards
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Generalized Seizures: Absence or Petit Mal
 Brief loss of consciousness with little or no
alteration in muscle tone
 May go unnoticed
 May include “blank stare” for 5 to 10 seconds
 May drop an object as lose muscle tone
 May have minor movements such as lip
smacking or twitching
 Inability to recall what happened afterwards
Generalized Seizures: Atonic
 Sudden, momentary loss of muscle tone
 May or may not lose consciousness
 May be mild such as brief head drop or
 Severe: fall to ground, lose consciousness
briefly, then get up as though nothing
happened
Partial Seizures: Simple
 Manifestations depend on area of brain
affected.
 May or may not lose consciousness or be
aware of seizure.
 Example: eyes or eyes and head may
turn to one side and the arm on that side
may be extended with fingers clenched.
Partial Seizures: Complex
Most common type.
May begin with aura such as odd taste or
smell and/or visual hallucinations.
May cry out then suddenly become
unaware of surroundings and unable to
respond.
May become limp or stiff and appear
dazed, confused and apathetic.
Basic Seizure Management
 Protect student
 Observe: Note which parts of body
involved and duration.
 Get medical assistance when needed: A
series of seizures without regaining
consciousness or a seizure lasting longer
than 5 minutes can be a medical
emergency.
Managing a Seizure in the School
Setting
Each student with a known
seizure disorder should have a
Seizure Action Plan* on file in
the school health office.
Procedure for Managing a Seizure
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If student has a known seizure disorder, follow plan.
Remain calm – seizure can’t be stopped once it starts.
Have an adult monitor the student.
Note exact time of onset.
Put on gloves, if available.
Place student on side. If possible, put something soft
under student’s head.
Do not place anything in student’s mouth.
Document: time seizure began, body part involved and
any movement from one part to another, type of
movements of head, face, arms.
Call Emergency Medical Services
911 if:
Student stops breathing
There is evidence of injury
Student is diabetic or pregnant
Seizure lasts more than 5 minutes
Pupils are not equal in size after seizure
Student cannot be awakened after seizure
Student vomits continuously after seizure
This is student’s first seizure
After Seizure
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Monitor breathing. Check position of head and tongue.
Determine level of awareness. Note if alert, confused,
drowsy, etc.
Determine if student is able to move limbs.
Check for injuries and provide care if needed. If
student remains unconscious maintain open airway
and continue to assess.
Check for loss of control of urine and stool.
Provide comfort measures.
Document length of seizure and what happened during
and after.
Call or have someone call parents promptly.
Rectal Diazepam
Some students with known seizure
disorders have a medication prescribed by
a doctor to be administered if the seizure
lasts more than 5 minutes. This must be
in the student’s care plan with both parent
and physician signatures.
Procedure for Administering Rectal
Diazepam (Diastat) at School
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Don gloves.
Obtain assistance of other adult, if possible.
Remove protective cover from the medication syringe and lubricate
the rectal tip with the jelly in the package.
Turn student on side (left preferably) facing you. Bend the upper
leg forward and separate the buttocks to expose the rectum.
Gently insert the syringe tip into the rectum. The rim should be
snug against the opening. Slowly count to three while gently
pushing in the plunger.
Count to 3 again before removing. Hold the buttocks together and
count to 3 again.
Keep student on side and note the time.
9-1-1 must be called when diastat is given at school.
Observe for side effects.
Remove gloves and wash hands.
See following slides for simplified pictorial instructions
Diastat* Instructions
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Delegate call to 911.
Check orders and care plan.
Clear area of students and on lookers.
Put on gloves.
If student is in a wheelchair or car/bus seat child to
ground.
 Follow instructions on following slides.
 Call or delegate call to parents after diastat is
administered.
*Diastat information obtained from Valeant Pharmaceutical and is included here with permission for
educational purposes only. See http://www.diastat.com/HTML-INF/index.htm for additional
information.
Diastat Instructions
1.
Put student on side
he/she where can’t fall.
2.
Get the diastat kit.
3.
Get syringe. Note: Seal
pin is attached to cap.
Check dose in dial
window.
Diastat Instructions
4. Push up with thumb and
pull to remove cap from
syringe. Be sure seal
pin is removed.
5.
Lubricate rectal tip with
lubricating jelly.
6.
Turn student on side
facing you.
Diastat Instructions
7.
Bend upper leg forward
to expose rectum.
8.
Separate buttocks to
expose rectum.
9.
Gently insert syringe tip
into rectum. Rim should
be snug against rectal
opening.
Diastat Instructions
10. Slowly count to 3 while gently
pushing plunger until it stops.
11. Slowly count to 3
before removing
syringe.
12. Slowly count to 3
while holding
buttocks together.
13. Keep student on side
facing you, note time
and continue to observe.
Diastat Instructions
Disposal Instructions:
For AcuDial: After 14a
put syringe in box or
bag and give to
rescue squad
personnel.
For 2.5 mg syringe put
syringe in box or bag
and give to rescue
squad personnel.
How to Administer Diastat Video
For a video demonstration on administering
Diastat go to:
http://www.diastat.com/HTMLINF/Admin_Diastat/Admin_Diastat/How_to
_Administer_Video.htm