Get Seizure Action Plan - Chilton.k12.wi.us - Chilton K12 Wi

Filling out the Seizure Action Plan is essential for ensuring the safety and proper care of students with seizure disorders during school hours. This comprehensive guide provides step-by-step instructions to help users navigate the form efficiently and effectively.

Follow the steps to successfully complete the Seizure Action Plan.

1. Click the ‘Get Form’ button to access the Seizure Action Plan. This will allow you to open the document and start filling it out online.
2. Begin by entering the student’s name and the names of the parent or guardian responsible for the student. Ensure that you provide accurate contact information, including phone numbers.
3. Provide details about the treating physician, including their name and contact information. This information is crucial for any medical emergencies.
4. Fill in significant medical history relevant to the student's condition. This should include any previous seizures or related medical issues.
5. Record information about the seizure type, length, frequency, and description. Additionally, detail any seizure triggers or warning signs that staff should be aware of.
6. Describe the student’s reaction to seizures. This could include behaviors exhibited before, during, or after a seizure.
7. Outline the basic first aid procedures that should be followed in the event of a seizure. Include steps to ensure the safety and comfort of the student.
8. Indicate whether the student needs to leave the classroom after a seizure. If yes, describe the process for returning them to class.
9. Define what constitutes a seizure emergency for this student and provide a clear protocol for emergency responses. Ensure to check all relevant response options.
10. Detail the treatment protocol for school hours, including the medications the student requires, their dosages, administration times, and any side effects.
11. State whether the student has a Vagus Nerve Stimulator (VNS) and describe how to use it.
12. Include any special considerations or safety precautions by the school for activities, trips, or sports associated with the student.
13. Confirm permissions for the school nurse or delegates to administer medications as outlined in the plan and note any necessary signatures from parents and physicians.
14. After completing all sections of the form, review the information entered for accuracy. Save changes, download, or print the form as needed.

Complete your Seizure Action Plan online today to ensure a safe environment for students.