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Administration of rectal diazepam.
Things to consider.
Sometimes children with seizure disorders can have prolonged seizures.
Longer seizures may contribute to complications.
Depending on the student’s seizure emergency plan,
medication for prolonged seizures may be needed.
Given that when a child is having a seizure, it can be a stressful situation,
it is highly recommended that you familiarize yourself
with the student’s seizure emergency plan beforehand.
Store the seizure emergency plan in a location that is
easily accessible during a seizure.
The correct dose of rectal diazepam ordered by the healthcare provider
should be locked into place on the device by the dispensing pharmacist.
This is evident when the green “READY” is visible.
Be sure to check expiration date on the medication package.
Remember to keep healthcare information confidential.
First aid for a seizure.
Call for assistance if someone else is present.
Place the child on a flat surface, such as the floor,
being sure not to move the child any more than is necessary.
Turn the child onto their side to allow vomit or phlegm
to be expelled rather than inhaled.
Place something soft under the child’s head to protect them from injury.
Identify that symptoms of a prolonged seizure are present and that,
based on the child’s seizure emergency plan, medication needs to be given.
Note time of seizure onset.
Call for assistance if you have not already done so.
Assemble supplies and place on a clean surface.
Check the medication kit and the medical order to be sure it is . . .
Also check to ensure the medication has not expired.
Follow the student’s healthcare plan
and ensure the appropriate amount of time has passed
prior to administering the student’s seizure medication.
Ask that another school staff person call 911
or emergency medical services, and notify parent.
Wash your hands if possible.
Put on gloves.
Re-check the medication kit and medical order to be sure it is . . .
Make sure the delivery device is in the “READY” mode.
While providing the student with as much privacy as possible,
remove clothing from buttocks
and drape the buttocks with a blanket, pillowcase, or other barrier.
Push up on the cap with your thumb and pull to remove the cap from the syringe.
Open the package of lubricant.
Lubricate the tip by inserting it into the lubricating jelly.
Move the student to a side-lying position
with the upper leg forward so the rectum is exposed.
Using non-dominant hand, separate the buttocks to expose the rectum.
Using dominant hand, gently insert the syringe into the rectum
until the rim is snug against the rectal opening.
Push the plunger in slowly counting to 3 until the plunger stops.
Hold the syringe in place after inserting the medication and count to 3.
Remove the syringe from rectum.
Immediately hold the buttocks together and count to 3 again.
This helps keep the medication from leaking out.
Keep the student on his or her side.
Keep blanket, pillowcase, or other barrier in place
to provide privacy for the student.
Note time of medication administration.
If alone, and you have not already done so,
call 911 or emergency medical services now.
Monitor seizure activity and respiratory effort.
If breathing stops, begin rescue breaths.
If breathing and heartbeat stop, begin CPR.
Once rescue squad arrives, inform them of medication administered,
including type of medication, dose, and time.
Remember to dispose of all used equipment and medicine
safely out of the reach of children.
Remove gloves and wash hands.
Document the date, time, and dose of medication given,
in addition to what was observed during the seizure.
Follow up with the parent or guardian and healthcare provider as needed.