Diastat Training Module
Natomas Unified School District
Objectives
Upon completion of the Seizure/Diastat training you
will demonstrate and/or verbalize:
1. Recognition and treatment of different types of
seizures
2. Administration of an emergency anti-seizure
medication
3. Management of seizures in the school setting based
upon the physician’s orders and seizure medication
authorization
Objectives Continued
4. Safe and correct management of pupil requiring
Diastat during a seizure.
5. Basic emergency follow-up procedures
6. Techniques and procedures to ensure pupil privacy
7. Record keeping requirements
Pre-Test
 Take Pre-test
 Answers will be reviewed at the end of the
presentation.
Procedure for Diastat at School
 Parent request/consent for Emergency Antiseizure medication.
 Physician authorization for Emergency Antiseizure medication.
 Seizure Emergency Action Plan completed by
doctor.
 Electronic request for volunteers is sent out.
 Volunteer must have current CPR.
 Agreement to administer Diastat is voluntary.
Continued
 Volunteer must complete training before giving
medication.
 Documentation of completed training must be retained
in volunteer’s personnel file.
 Volunteer may rescind offer to administer Diastat up to
three days after training. After that time, volunteer may
rescind offer to administer with a two week notice.
 Volunteering to administer Diastat is student specific.
Continued
 Volunteer must report every administration of Diastat to
the School Administrator and the District Nurse.
 Retraining is required every yearly.
 Periodic review with volunteer can be done by the
district nurse throughout the school year.
What is Diastat?
 Diastat is a gel form of Diazepam
 Used for emergency seizure situations
 Anti-seizure medication
Mechanism of Diastat Action
 Diazepam belongs to a class of medications called
benzodiazepines which produce a calming effect on the
brain and nerves (central nervous system).
 It is thought to work by increasing the effect of a
certain natural chemical (GABA) in the brain.
Types of Seizures requiring
Diastat
 There are two types of seizure emergencies:
 Status Epilepticus – a prolonged clonic-tonic seizure
lasting for an extended period of time. This period of
time is determined by the student’s physician. For
some it is 5 minutes for others it is less and some
more.
 Acute Repetitive Seizure – a series of seizures or
cluster seizures, each lasting a short period of time.
In between seizures, the student regains
consciousness.
Indicators for Diastat
administration
 This medication is used to treat episodes of increased
seizures (e.g., acute repetitive seizures, breakthrough
seizures) in people who are already taking medications
to control their seizures.
 This product is only recommended for short-term
treatment of seizure attacks. It is not for ongoing daily
use to prevent seizures.
 Uncontrolled seizures can turn into serious (possibly
fatal) seizures that do not stop (status epilepticus).
Side Effects of Diastat
Mild side effects might be:
 Drowsiness/sleepiness
 Dizziness
 Diarrhea
 Unsteadiness
Side Effects of Diastat
More severe side effects might be:
 Slow/shallow/difficult breathing
 Mental/mood changes (e.g., anxiety,
restlessness, hallucinations, sleep problems)
 Slurred speech
 Trouble walking.
Allergic Reaction to Diastat
Symptoms include:
 Rash
 itching/swelling (especially of the face
tongue/throat)
 dizziness
 trouble breathing
Contraindications
 Diazepam is contraindicated in patients with a known:
 Known hypersensitivity to this drug.
 If Diastat has been given within 4 hours prior at
home.
 Because of lack of sufficient clinical experience, in
children under 2 years of age.
 Contraindicated in acute narrow angle glaucoma.
Standard Procedure for
Administering Diastat
1. Time the seizure and get ready to administer the
Diastat.
2. If orders state that Diastat is to be given immediately
proceed to the following steps below.
3. Have someone call 9-1-1
4. Place the student on their side, where they cannot fall.
5. Get the medication or have someone get it from the
locked area and bag with blanket..etc.
Standard Procedure for
Administering Diastat
6. Get the syringe out
7. Push up with your thumb and pull to remove the cap
fromthe syringe (Be sure seal pin is removed with
the cap)
8. Lubricate rectal tip with lubricating jelly.
9. Turn student on the side facing you.
10.Bend their upper leg forward to expose rectum.
11.Separate buttocks to expose rectum.
Standard Procedure for
Administering Diastat
12. Gently insert syringe tip into rectum. (Rim of syringe
should be snug against rectal opening)
13.SLOWLY count to 3 while gently pushing plunger in
until it stops.
14. SLOWLY count to 3 before removing syringe from
rectum.
15.SLOWLY count to 3 while holding buttocks together to
prevent leakage.
16.Keep student on the side facing you, note time given
and continue to observe.
Follow-up and Observations
After Administering Diastat
 Watch breathing pattern of student
 Begin CPR if student stops breathing or as needed.
 Continue to observe
 Remain with the student. Never leave a student
having a seizure unattended.
 Continue to time the seizure until it has stopped
 Never put anything in the mouth of someone having a
seizure.
Pupil Privacy
 Request another staff member move other pupils away
from area.
 Have someone get the emergency treatment packet for
the student (which should be kept in a private place for
confidentiality).
 Have a bag which contains a blanket or other
appropriate article to be used to cover pupil and avoid
exposure and a small item like a jacket to place under
the head (provided by parent).
Documentation and Records
 Complete Seizure Log and Seizure Incident Report.
 This documentation includes:
 Pupil name
 Name of medication
 Dose
 Date
 Time given
 Length of seizure
 Observation
 Status of pupil
 Action taken after seizure
 Provide copy to school nurse.
Emergency Care Plans
 Chain of responsibility regarding Diastat administration in
the school setting, i.e.,
 Physician (Doctor’s orders)
 Parent (request for unlicensed personnel to administer Diastat)
 Administration (sending out email to request volunteers)
 Trainer of volunteer (District Nurse)
 Volunteer (Teacher, secretary, aide, principal)
 EMS/911.
 Review the pupil’s Seizure Emergency Action Plan (this is
only for the personnel directly responsible for delivering the
emergency care).
Video
Review
 Questions
 Review:




Seizure log
Facts for school personnel
Seizure Emergency Action Plan
Physician’s Authorization
 Practice scenarios on Nickie ® Training Doll
 Take Post-test
 Go through checklist
References
https://healthy.kaiserpermanente.org/health/care/consume
r/health-wellness/drugs-and-natural-medicines
 https://www.epilepsy.com
 http://www.druginformation.com/RxDrugs/D/Diazepam
%20Rectal%20Gel.html
 California School Nurses Organization. (2012).
http://www.csno.org/diastat-issues/
Resources
 Epilepsy Foundation Northern California 155
Montgomery Street Suite 309, San Francisco,
California 94104-4108. Phone: (415) 677-4011Toll
Free: (800) 632-3532. http://www.epilepsy.com
 Diastat AcuDial Epilepsy & Seizure Resource Center.
Back To School. http://www.diastat.com/resourcecenter#school
 WebMD http://www.webmd.com/drugs/drug-94251Diastat+AcuDial+Rect.aspx?drugid=94251&drugname
=Diastat+AcuDial+Rect