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- Seizures
Seizure Care Plan
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Gainesville ISD Health Services
Seizure Emergency Treatment Plan
Student Name__________________________ Age_______ Weight__________
Treatment/Medication: ________________________mg: Route: ________ prn for:
_____ seizure > ____ minutes—OR for _____ seizures in _____ hours
_____ Use vagal nerve stimulator (VNS) magnet other _________________
_____Call 911 immediately and administer rectal gel
OR
Call 911 if:
_____ Seizure does not stop by itself or with VNS within _____ minutes
_____Seizure does not stop by itself within ______ minutes
_____Seizure does not stop within ____ minutes of giving diazepam rectal gel
_____Child does not start waking up within _____ minutes after seizure is over
(no diazepam rectal gel given)
_____Child does not start waking up within ____ minutes after seizure is over
(after diazepam rectal gel is given)
Following a seizure:
_____Child should rest in the nurse’s office _____Child may return to class
_____Parents should be notified immediately
_____Parents should receive a note/copy of the seizure record sent home with the child
Current Medications:______________________________________________________
Allergies________________________________________________________________
Type of seizures Description*
Absence: Staring, eye blinking, loss of awareness, other___________
Simple partial Remains conscious, Involuntary rhythmic jerking/twitching on one side,
Seizures: distorted sense of smell, hearing , sight, other_____________
Complex partial Confused, not fully responsive/unresponsive, may appear
Seizures: fearful, purposeless, repetitive movements, other______________
Generalized tonic- Convulsions, stiffening, breathing may be shallow, lips or skin
clonic seizures: may have bluish color, unconsciousness, confusion, weariness, or belligerence when the seizure ends, other________________
Call parents under the following circumstances: ____________________________________
Physician Signature Printed Name Date
Physician Address________________________________Phone_________________________
____________________________________________________________________________
Parent Signature Date Phone