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Nd providing a positive and supportive learning environment. If you have any questions about how to complete this form, please contact your child s school nurse. CONTACT INFORMATION: Student s Name: School: Parent/Guardian Name: Other Emergency Contact: Child s Neurologist: Child s Primary Care Dr.: Significant medical history or conditions: School Year: Grade: Tel. (H): Tel. (H): Tel: Tel: SEIZURE INFORMATION: 1. When was your child diagnosed with seizures or epilepsy? 2. Seizure type.

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How to fill out the School Nurse Epilepsy Action Plan Form online

Filling out the School Nurse Epilepsy Action Plan Form online is essential for ensuring that your child receives proper care and support during school hours. This comprehensive guide will walk you through each section of the form, detailing what information is needed and why it is important.

Follow the steps to successfully complete the form.

  1. Click the ‘Get Form’ button to access the document online and open it in the editor.
  2. Begin by filling out the contact information section. Include your child’s name, school, your name as the parent or guardian, and any additional emergency contact details. Ensure all phone numbers are accurate.
  3. Provide relevant seizure information. Write down when your child was diagnosed, the type and frequency of seizures, and any potential triggers that may affect your child's condition.
  4. Detail your child's medical history and medications. This includes current medications, rescue medications, dosages, and any significant side effects or special administration instructions.
  5. Complete the basic first aid section for seizures. Outline the necessary comfort measures teachers and staff should follow during a seizure episode.
  6. Describe any special considerations or precautions that the school should take regarding your child's health and safety during activities.
  7. Review the emergency response protocols. Clearly state what constitutes a seizure emergency for your child, and ensure all necessary contacts are included.
  8. Finally, sign the form as the parent or guardian, indicating your consent for this information to be shared with appropriate school personnel. Save the completed form.

Start completing your School Nurse Epilepsy Action Plan Form online to help ensure your child's safety and well-being at school.

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Seizures take on many different forms and have a beginning (prodrome and aura), middle (ictal) and end (post-ictal) stage.

Maintain a calm tone to keep other students from panicking. Reassure and comfort the student if they experience confusion or fear following the seizure. Allow the student to remain seated in the classroom until awareness returns. Allow the student quiet rest time following the seizure.

medicines called anti-epileptic drugs (AEDs) surgery to remove a small part of the brain that's causing the seizures. a procedure to put a small electrical device inside the body that can help control seizures. a special diet (ketogenic diet) that can help control seizures.

Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, electrodes are attached to your scalp with a paste-like substance or cap. The electrodes record the electrical activity of your brain.

Keep other people out of the way. Clear hard or sharp objects away from the person. Don't try to hold them down or stop the movements. Place them on their side, to help keep their airway clear. Look at your watch at the start of the seizure, to time its length. Don't put anything in their mouth.

You must absolutely not: Hold the person down or attempt to restrain them in any way; this is very dangerous for everyone involved, as a person experiencing a seizure cannot control their movements. Attempt to put anything in their mouth.

While many forms of epilepsy require lifelong treatment to control the seizures, for some people the seizures eventually go away. The odds of becoming seizure-free are not as good for adults or for children with severe epilepsy syndromes, but it is possible that seizures may decrease or even stop over time.

Missed medication, lack of sleep, stress, alcohol, and menstruation are some of the most common triggers, but there are many more. Flashing lights can cause seizures in some people, but it's much less frequent than you might imagine.

It isn't common for epilepsy to go away on its own. Long-term, recurring seizures usually can be controlled with treatment, which often includes taking medication. About 70 percent of people with epilepsy can control their seizures with medications or surgery.

What is a Seizure Action Plan? A Seizure Action Plan [PDF 41 KB] contains the essential information school staff may need to know in order to help a student who has seizures. It includes information on first aid, parent and health care provider contacts, and medications specifically for that child.

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