Seizure Protocol

FOR BREN SHUMATE

STAY CALM

You are going to feel rushed and scared, but it is imperative that you slow down and follow these instructions. She may convulse, turn blue, or her eyes may wander but you have to stay calm and follow the protocol.

MAKE A NOTE OF THE TIME, IT IS ABSOLUTELY VITAL TO HER SAFETY

Take a deep breath and make note of the time down to the second. It is crucial to know how long the seizure is going on. If someone is there with you ask them to be the timekeeper while you administer care.

GET HER TO A SAFE PLACE:

Ideally 6ft away from water, sources of heat, sharp objects etc. Don’t set her on anything she can fall off of, or any hard surface where she could flail and knock her head.

LAY HER ON HER RIGHT SIDE:

Tilt the chin slightly towards the floor to keep the airway open and help drool run out. Do not try to insert or remove anything from her mouth.

CALL 911:

Call them before calling anyone else. Ask someone else to call if they are there with you and put EMS on speaker. Tell them she takes Keppra and has Diastat rectal gel on hand.

CALL GUARDIAN:

If possible, ask someone else to do it so you can stay focused

Carie (Mom)– 843-601-5229
Drew (Dad) – 843-858-9976
Deborah (Grandma) – 843-618-7241

CHECK THE TIME AGAIN - 1 MINUTE MARK - READ THIS PARAGRAPH IT IS IMPORTANT!!!

Should be 1min or less at this point. Her lips or face may start to turn blue and her eyes may wander. That doesn’t mean she isn’t breathing. It will scare you, but stay calm. This is what it normally looks like. The important thing is to make sure she is breathing. Her seizures are usually 45 seconds to a minute so it may be resolving. You can start calling her name loudly, tapping the bottom of her foot, and gently rubbing her head to try and coax her back to awareness. She usually starts blinking, wiggling, or making crying noises when it starts to resolve.

MAKE SURE SHE IS BREATHING:

Lay your hand on her back or chest and feel for diaphragm movement. Put ear to her mouth and listen for air moving, notice if you feel breath hitting your cheek. If may sound faint or slightly labored but any air moving is a good thing. You can try rubbing her back and legs to stimulate breathing if she is not convulsing hard.

If she is continuing to breathe or starts to become aware, allow the seizure a little longer to resolve itself. If she is not breathing, move to rescue breathing highlighted in red below. If there is still air moving but the seizure isn't resolving move to next paragraph.

CHECK THE TIME AGAIN - 2 MINUTE MARK:

It would be abnormal for one of her seizure to last more than 2 minutes. STAY CALM. EMS IS ON THE WAY. If the seizure is unresolved at 2 minutes we want you to go ahead and administer the Diastat. You have our consent to do so.

DIASTAT:

She should be laying on her right side.
Take the leg on top (should be her left leg) and bend the knee up towards her chest as far as you comfortably can.
Take cap off of the Diastat Pen from her beige backpack and lubricate it with the supplied packet.
When ready, insert the tip into rectum until the guard prevents it from going any further.
Administer in 3/3/3 – 3 second to depress, 3 seconds left in rectum, 3 seconds cheek squeeze after removal
- DISPENSE SLOWLY…it should take 3 seconds for you to empty the tube. Don’t do one hard press, it will shoot out.
- Leave the tip in for 3 seconds while fully depressed, and then remove it
- Press her cheeks together and hold for 3 seconds so it can’ t come back out. This may cause her to poop. That’s normal.

AFTER DIASTAT OR IF SHE BECOMES UNRESPONSIVE YOU MUST ASSESS HER IMMIDIATELY

Take no more than 10 seconds to assess her doing the following
Lay her on her back
Tilt her chin up to the “sniffing” position. If you tilt back too far, it can kink the airway.
Listen for air, look / feel for chest rise
While listening for air check her carotid “neck artery for pulse. Put flat part of your first two fingers on her wind pipe and walk them towards the left ear until you feel the first “valley” that is where the carotid pulse can be felt.

THREE SCENARIOS COULD HAPPEN AT THIS POINT

1. The seizure will stop, she will return to awareness and start crying or responding

- Make a final note of the time when the seizure stopped and wait for EMS to arrive

2. She will have a pulse but is not breathing normally, move immediately to Rescue Breathing

RESCUE BREATHING

Make sure she is on her back an her head is still tilted to sniffing position. Don't tilt back too far it can kink the airway.
Make sure your mouth forms a tight seal over mouth and nose. If it doesn't, pinch the nose
You don’t have to blow hard, just hard enough to get a chest rise. Make sure not to suck air back out.
Administer 1 breath, every 3 seconds, for two minutes.
After two minutes recheck for pulse. If it is still there, continue rescue breathing again until EMS arrives

3. She will have no pulse and will not be breathing, you must move immediately to CPR.

CPR

Start by administering 2 rescue breaths with one second in between. Rescue breathing process highlighted in red above
Administer 30 chest compressions
- Draw an imaginary line from nipple to nipples and put the heel or your dominant hand right on the sternum.
- Lock your elbow and lean forward so that your shoulder is directly over your hand. Use your body weight to press down 2 inches at 100 – 120 bpm for 30 compressions.
- Staying Alive by the Bee Gees is a good song to count to for BPM are (don’t lose count of your 30 compressions) I...I...I...I'm staying alive, staying alive
- Even though it may be scary, you have to press hard enough to push blood out of the heart and let it recoil fully after each compression like a sponge filling back up. If you are doing to right, you may hear creaking and popping, you may even break a rib or sternum, but remember….the alternative is death.

After 30 compressions, check for pulse and breathing again. If neither are present, continue until EMS arrives.

If pulse returns but breath is abnormal, continue rescue breathing until EMS arrives.

USE AED ONLY AT EMS DIRECTION