Abstracts

Providing effective seizure treatment in the school setting is important for students, parents, and school personnel. Seizures are emergency situations necessitating rapid termination to minimize risk of long-term neuronal damage. The development of a seizure emergency treatment plan can empower school personnel to quickly and confidently treat seizures and enable students to quickly resume their usual activities. Diazepam rectal gel, a portable rescue medication for the treatment of breakthrough seizures, can be an effective part of the treatment plan. This presentation addresses strategies employed by the Central Virginia Region School District and surrounding counties to establish seizure emergency treatment plans and to train medical and nonmedical school personnel in the administration of diazepam rectal gel. It also evaluates some of the challenges encountered in adopting these plans. We interviewed school health personnel and parents of children with seizures to assess how they were trained in the use of diazepam rectal gel and their level of satisfaction with the medication. Data represent responses from schools in 20 counties. In the majority of elementary schools, care is provided by a full time health assistant/aide and itinerant nurse who travels between schools. The majority of middle schools and high schools employ a full time nurse. Training for all school health personnel was the same. We provided direct, hands-on training at 3 schools. For the remainder of schools, we have trained the head nurse of each county program in the use of diazepam rectal gel at the State Nurses Meeting over the past 2 years; the head nurses then train the necessary health personnel in their own schools. At the meeting, the head nurses were given an instructional video, an empty syringe system for demonstration purposes, an administration sheet, and a question sheet. When diazepam rectal gel is ordered for use in a school, we send our 5-page seizure protocol that provides specific direction regarding when diazepam rectal gel should be given, when to administer a second dose, and when to call a rescue squad. The school aides reported feeling very comfortable with the administration of diazepam rectal gel; they felt that it was easy to use and very effective. Parents also reported feeling very comfortable having diazepam rectal gel in the schools. They were relieved that it was available and described it as easy to use. School health personnel in our district have demonstrated success in implementing the seizure emergency treatment plan; case studies describing effective administration of diazepam rectal gel and challenges to its use will be reported. The development and implementation of a seizure emergency treatment plan incorporating diazepam rectal gel empowers students, parents, and school personnel to feel more confident in safely and quickly terminating breakthrough seizures. (Supported by Xcel Pharmaceuticals)