Medical Emergencies - Epilepsy

Teachers’ recognition of epileptic medical emergencies

Each student’s specific first aid and related plan should be constructed with the help of his/her doctors. However, normally 911 does not need be called when a student known to have epilepsy experiences a seizure. Several situations, however, do warrant a 911 call:

  • A seizure lasts longer than 5 minutes (a serious condition known as status epilepticus)
  • A student fails to regain consciousness after a seizure
  • A student has no prior history of seizures

Seizure-related head trauma warrant a 911 call if: 

  • The student is difficult to rouse 20 minutes after the seizure
  • Consciousness is difficult to maintain
  • There is vomiting
  • Vision problems are reported
  • Excessive sleepiness appears
  • A persistent headache is present after a period of rest
  • Weakness in limbs are seen or reported

If a seizure occurs that does not require medical emergency services, basic first aid is generally called for. It is important to keep calm, and reassure classmates that the student will be all right. If the child has a convulsive seizure (not just transient changes in consciousness or seizure-related movements), most experts suggesting easing the student to the floor and clearing the immediate area. A soft, flat, object (such as a folded towel) can be put under the student’s head. Next, gently turn the student on his or her side so that the airway is clear. DO NOT try to put something in the child’s mouth, hold the mouth open, hold the tongue, or try to restrain the child.  Let the child rest after convulsions have stopped and the child begins to regain consciousness. The child should begin normal breathing again once the seizure stops and CPR is rarely needed. If the child does not begin to breathe normally, check his or her airway for obstruction. A child may lose bowel and bladder control during a seizure. Thus, a student’s individualized plan may specify that a change of clothes is kept at school. During some seizures, the student may walk around in an undirected, aimless way and fail to respond when spoken to. If this is the case, the teacher should gently and calmly guide the child back to his or her seat.

Teachers’ emergency actions

Most students Seizure Action Plan will indicate that school personnel should call 911 when:

  • A seizure lasts longer than 5 minutes (a serious condition known as status epilepticus),
  • Consciousness is not regained after a seizure ,
  • A cluster of seizures occur close together in time (a serious condition known as status epilepticus),
  • The student has no prior history of seizures.

Teachers should follow the student’s individualized plan. However, if a plan is not yet developed, most experts say that teachers should contact the school nurse immediately, and he/she may call 911 or otherwise manage the situation. If there is no school nurse, then the child’s physician must be contacted and 911 should be called by the teacher.

Additionally, a head trauma during a seizure-related fall might prompt emergency action.  This is true if the student:

  • Struggles to regain full consciousness for 20 minutes after the seizure
  • Has difficulty maintaining consciousness
  • Is vomiting
  • Has vision problems
  • Has excessive sleepiness
  • Has a persistent headache after period of rest
  • Has weakness in his or her limbs.

EdMedKids provides a link to a seizure observation form developed by the Epilepsy foundation.