School Nurse Seizure Disorder Newsletter: Protocols and Support

Seizures are frightening to witness, especially for educators who have not seen one before. A well-trained staff that has a current seizure action plan in hand and knows exactly what to do responds calmly and effectively. A staff that receives no preparation responds with panic and delay. The difference is communication, and it starts before the school year begins.

Explain What a Seizure Action Plan Is and Who Needs One

Every student with a diagnosed seizure disorder attending school must have a current seizure action plan on file with the nurse. This plan is completed by the student's neurologist or treating physician. It describes the type of seizure the student experiences, what it looks like, the typical duration, what happens after the seizure (postictal phase), how staff should respond, whether rescue medication is prescribed, and when to call 911. Plans older than 12 months need to be updated. Families should not assume last year's plan is still active.

Describe Seizure First Aid for Staff

Walk through the basic response: stay with the student and keep calm; clear the immediate area of hard objects or furniture; turn the student gently onto their side if there is vomiting or if they are unconscious; do not restrain any movement and do not put anything in the student's mouth; time the seizure with a clock or phone; stay with the student through the postictal recovery period; call 911 per the action plan thresholds. These steps are simple but must be rehearsed to be used correctly under stress.

State When to Call 911

The general thresholds for calling 911 are: any seizure lasting more than five minutes; a second seizure within 24 hours; the student does not return to baseline consciousness within five minutes of the seizure ending; breathing difficulty is observed; the student is injured; or this is the first known seizure. Note that a student's individual action plan may have more specific thresholds based on their seizure history. The action plan governs; the general guidelines apply when no plan is available.

Cover Rescue Medication Protocols

Some students with seizure disorders have a prescription for rectal diazepam, nasal midazolam, or another rescue medication to stop a prolonged seizure. When this is prescribed, the nurse trains the designated staff members in its administration and the action plan specifies when and how to use it. The rescue medication does not replace calling 911; in most protocols it is administered while 911 is en route. Families should ensure the rescue medication kept at school is current and within the labeled expiration date.

Template Excerpt: Seizure Protocol Staff Reminder

Here is a section you can adapt for the newsletter:

"If you witness a seizure: (1) Stay calm and stay with the student. (2) Clear hard objects from around the student. (3) Turn the student on their side if they vomit or are unconscious. (4) Do not restrain movement or put anything in the mouth. (5) Time the seizure. (6) Call 911 if the seizure lasts more than five minutes or if the student does not regain consciousness. (7) Notify the nurse immediately. Follow the student's individual seizure action plan for any additional steps."

Describe the Post-Seizure Support Protocol

After a seizure, a student typically enters a postictal phase: confusion, fatigue, headache, or muscle soreness that can last from 15 minutes to several hours. The student should not return to class until they have returned to baseline alertness. A parent should always be called after a seizure episode at school regardless of the seizure's duration. Note whether the student is expected to go home following a seizure, rest at school if cleared by the parent, or be transported by ambulance to an emergency room. The action plan specifies this protocol individually.

Address Physical Education and Recess Safety

Students with seizure disorders have the right to participate in physical education and outdoor activities with appropriate supervision. For students with aquatic activities, a trained adult must maintain direct line-of-sight supervision. For high-ropes or climbing activities, a physician note may be needed to clear participation. In general, outdoor recess on hard surfaces should involve a staff member positioned near the student who knows the seizure protocol. These accommodations should be part of the student's 504 plan or IEP if applicable.

Close With Staff Training and Nurse Contact Information

End with a note that all staff working with a student who has a seizure disorder receive individual training from the nurse before working with that student, and that families can request confirmation of which staff members have been trained. Give the nurse's direct phone number and email. Invite families to schedule a pre-school meeting to review the action plan, verify supplies, and meet the teacher. A family who knows the school is prepared before the first day has measurably less anxiety throughout the year.