Are we failing to provide adequate rescue medication to children at risk of prolonged convulsive seizures in schools?
Identifieur interne : 000058 ( France/Analysis ); précédent : 000057; suivant : 000059Are we failing to provide adequate rescue medication to children at risk of prolonged convulsive seizures in schools?
Auteurs : J Helen Cross [Royaume-Uni] ; Suzanne Wait [Royaume-Uni] ; Alexis Arzimanoglou [France] ; Ettore Beghi [Italie] ; Christine Bennett [Royaume-Uni] ; Lieven Lagae [Belgique] ; Janet Mifsud [Malte] ; Dieter Schmidt [Allemagne] ; Gordon Harvey [Belgique]Source :
- Archives of Disease in Childhood [ 0003-9888 ] ; 2013-10.
Abstract
Objective This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK. Situation analysis Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. Recommendations A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. Implications Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall.
Url:
DOI: 10.1136/archdischild-2013-304089
Affiliations:
- Allemagne, Belgique, France, Italie, Malte, Royaume-Uni
- Angleterre, Berlin, Grand Londres, Région de Bruxelles-Capitale
- Berlin, Bruxelles, Londres, Lyon
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Situation analysis Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. Recommendations A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. Implications Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Belgique</li><li>France</li><li>Italie</li><li>Malte</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Berlin</li><li>Grand Londres</li><li>Région de Bruxelles-Capitale</li></region><settlement><li>Berlin</li><li>Bruxelles</li><li>Londres</li><li>Lyon</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Cross, J Helen" sort="Cross, J Helen" uniqKey="Cross J" first="J Helen" last="Cross">J Helen Cross</name></region><name sortKey="Bennett, Christine" sort="Bennett, Christine" uniqKey="Bennett C" first="Christine" last="Bennett">Christine Bennett</name><name sortKey="Cross, J Helen" sort="Cross, J Helen" uniqKey="Cross J" first="J Helen" last="Cross">J Helen Cross</name><name sortKey="Wait, Suzanne" sort="Wait, Suzanne" uniqKey="Wait S" first="Suzanne" last="Wait">Suzanne Wait</name></country><country name="France"><noRegion><name sortKey="Arzimanoglou, Alexis" sort="Arzimanoglou, Alexis" uniqKey="Arzimanoglou A" first="Alexis" last="Arzimanoglou">Alexis Arzimanoglou</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Beghi, Ettore" sort="Beghi, Ettore" uniqKey="Beghi E" first="Ettore" last="Beghi">Ettore Beghi</name></noRegion></country><country name="Belgique"><noRegion><name sortKey="Lagae, Lieven" sort="Lagae, Lieven" uniqKey="Lagae L" first="Lieven" last="Lagae">Lieven Lagae</name></noRegion><name sortKey="Harvey, Gordon" sort="Harvey, Gordon" uniqKey="Harvey G" first="Gordon" last="Harvey">Gordon Harvey</name></country><country name="Malte"><noRegion><name sortKey="Mifsud, Janet" sort="Mifsud, Janet" uniqKey="Mifsud J" first="Janet" last="Mifsud">Janet Mifsud</name></noRegion></country><country name="Allemagne"><region name="Berlin"><name sortKey="Schmidt, Dieter" sort="Schmidt, Dieter" uniqKey="Schmidt D" first="Dieter" last="Schmidt">Dieter Schmidt</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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