Seizure Major Generalised with INM First Aid Guide 2007

Afirstaidguideforeducationandchildren’sservices

Seizure–majorgeneralised

(includinguseofintranasalmidazolam)

NOTEtimeofseizureonset

CALLAMBULANCEIF:

Injurysuspected Breathingdifficulty

Requiredbyperson’shealthsupportplan

PROTECTfrominjury

DONOTrestrictmovement

LEAVEINWHEELCHAIR/SEAT/PRAMifthisisthesiteofseizureonset

REMOVEobjectswhichmaycauseharm

DONOTattempttoputanythingintothemouthduringseizure

MONITORairway–supportjawifneeded

GENTLYrollontoside(RECOVERYPOSITION)assoonasable

LEAVEINWHEELCHAIRaslongasaclearairwaycanbemaintained

CONVULSIVEACTIVITY

lastsformorethan3minutes(child)/

5minutes(adult)

CONVULSIVEACTIVITY

stopswithin3minutes(child)/

5minutes(adult)

CALLAMBULANCEGIVEMIDAZOLAMAS

PRESCRIBEDintothenose

RETURNtorecoveryposition

OBSERVE:Airway Breathing Signsoflife

SEIZUREACTIVITYRESUMES

RESUMEACTIVITYAFTERFULLRECOVERY(withinanhour)*

RECORD*Ifstillrecoveringafteronehourseizureactivityin INFORMEMERGENCYCONTACTSindividualseizurelog toarrangerecuperationathome

Seeoverfordetailsonadministeringintranasalmidazolam(INM)

TOCALLAMBULANCE:Dialout,then000ormobile112

Saywhatstateyouarecallingfrom,theperson’sconditionandlocation

INFORMEMERGENCYCONTACTSinaccordancewithDECSguidelines

DepartmentofEducationandChildren’sServicesSAwithexpertadvicefromAustralianRedCrossSADivisionandStJohnAmbulanceAustraliaSAInc,2007andTheEpilepsyCentreSA

Pre-requisites for safe first aid administration of intranasal midazolam (INM)

Thepersonadministeringintranasalmidazolamrequiresknowledgeofbasicfirstaidandseizure

management,andtobeauthorisedtoadministerbytheiremployer/agency/service.

ThepersonforwhomINMisorderedmusthavehadapreviousdoseofmidazolamwithoutadverse

effect.

Onlyaplasticampoulecontaining5mgin1mlcanbeused.

Ifmidazolamisgiveninschool,preschoolorchild/care,anambulancemustbecalled.

Refertotheperson’sseizurecareplanandseizurefirstaidplan.

Givingintranasalmidazolam(INM)

1.Notetimeofonsetofseizure

2.Checkadministrationdetailsonsignedspecialistauthority

3.Checkthatthemedicationauthoritymatcheslabelonbox

4.Checkexpirydateonampoule

5.Checkampouleis5mgin1ml

6.Decidewhichsideofpersontoworkfrom(person’sheadtoyourleftifyouarerighthanded)

7.Turnpersononbackwithheadslightlyextended,orpositionin

2wheelchairsoheadisbackandairwayopen

8.Twisttopoffampoule,andinvert

9.Squeezeampouletodropout1-3dropsintoeachnostriluntilampouleempty.Ifmovementmarked,gomoreslowly1dropatatimetogetintonose.Don’trush;thefirstfewdropsshouldhelp

3slowseizuresootherdropsareeasiertogetin

10. Assoonaspracticable,turnpersonontosideinrecoverypositionorsupportheadinwheelchair,maintainclearairway

11. Notetimeseizurestops

12. Staywiththeperson;followthestandardfirstaidpracticeuntilambulancearrives(followperson’shealthcareplanrecalling

4ambulance)

13. Keepemptyampouletogivetoambulanceofficers

14. Nothingbymouthuntilthepersonstartsconsciousmovements,(gagreflexisreduced)

15. Document.

TOCALLAMBULANCE:Dialout,then000ormobile112

Saywhatstateyouarecallingfrom,theperson’sconditionandlocation

INFORMEMERGENCYCONTACTSinaccordancewithDECSguidelines

DepartmentofEducationandChildren’sServicesSAwithexpertadvicefromAustralianRedCrossSADivisionandStJohnAmbulanceAustraliaSAInc,2007andTheEpilepsyCentreSA