Understanding Epilepsy and Administration of Midazolam

A person with epilepsy…

May only have one type of seizure
Will have seizures that will always become tonic-clonic
May have several different types of seizure
Will usually have seizures that stop by themselves

The characteristics of a tonic phase (of a tonic-clonic seizure) are…

Rigid body
Not breathing
Unconsciousness
Jerking
Fussing with clothes

The characteristics of the clonic phase (of a tonic-clonic seizure) are…

Wandering around
Jerking
Unconsciousness
Abnormal breathing
A strange taste

Epilepsy can be caused by…

Head injury
Stroke
Brain infection
Developmental defects

Anti-epileptic drugs…

Are used to control epilepsy more often than surgery
Control epilepsy in the majority of cases
Need to be taken regularly
Always prevent the seizures

Known triggers for seizures are…

Lack of sleep
Alcohol / illegal drugs
Anxiety / stress
Missing anti-epileptic drugs

At the start of a seizure you should always…

Put something between the person's teeth
Go for help
Note the time
Stay with the person

During a seizure you should…

Clear a space around the person
Protect the person's head
Give them a drink
Protect the airway

You should call an ambulance if…

The person is injured beyond first aid
The seizure is prolonged and the person has not been prescribed emergency medication
The person is drowsy but OK
The emergency medication protocol was followed but the emergency medication has not stopped the seizure
It is the person's first seizure

Status Epilepticus can…

Lead to brain damage
Be fatal
Be convulsive
Occur in absence and focal seizure

Which of the following tests look at electrical BRAIN activity to help diagnose epilepsy…

Blood tests
Urine test
ECG
EEG

Signs that a tonic-clonic seizure has stopped are…

Jerks are further apart
Jerking has stopped
Normal breathing returns
Their colour improves
Person holds their breath

After a seizure you should…

Put the person in the recovery position if appropriate
Check airways and breathing
Leave the person unattended to recover
Record the seizure

On an emergency protocol you would find…

Name of the person
Dose and type of medication
Person's blood group
Doctor's/health professional's signature

You can only administer emergency medication if…

You are trained to do so
The medication is in date
It is prescribed
The emergency protocol has been signed by a prescribing professional, e.g. doctor or nurse

Side effects of emergency medication can be…

Drowsiness
Disorientation
Weight gain
Visual disruption
Breathing slowed

Possible difficulties in the administration of buccal midazolam are….

Incontinence
Facial injury
Vomit
Excessive saliva
Diarrhoea

Having epilepsy can make a person more likely to develop…

Generalised Anxiety Disorder
Diabetes
Obsessive Compulsive Disorder
Asthma
Depression

Midazolam should be absorbed in the buccal cavity, found….

Between the lower cheek and gum
Under the tongue
Beside the teeth
On the lips

The dose should be split between both cheeks to allow the medication a greater area for absorption, however, it is acceptable to deliver the whole dose in one place if…

Access is restricted, e.g. the person has become trapped under furniture
They have sustained a facial injury on one side
The person has tipped onto their side and can not be manoeuvred into a better position
They have sustained a facial injury on one side
Their movements are such that administering to one side appears quicker, and safer

Individual risk assessments should cover…

Storage of medication
Disposal of medication
Recording of medication
Transport of medication
How to handle suspected overdoses
Staff training in place

We avoid delivering midazolam onto the teeth because…

It destroys the enamel of the teeth
Teeth do not absorb medication
Midazolam causes toothache

A second dose can be given if…

The emergency protocol says it can be delivered if the first dose is unsuccessful
A medical professional, e.g. paramedic, instructs you to do so
The person's parent / guardian says it's necessary
You administered the first does but it was only partially absorbed, e.g. the person vomited shortly after administration
You are in a rush to move the person

Medication checks should include…

Expiry date
Dosage
Medication records and date / time of last dose
The colour and transparency of the mediation (if possible)
Tamper-proof seals and stickers

How much medication is in this syringe?

1ml
0.55ml
0.5ml
0.6ml

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Understanding Epilepsy and Administration of Midazolam

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