This document provides information about epilepsy for healthcare staff. It begins with learning outcomes around recognizing seizure types, appropriate first aid, risks of epilepsy, and the role of staff caring for people with epilepsy. It then defines epilepsy as a neurological disorder characterized by unprovoked seizures. Several types of seizures are described, including focal and generalized seizures like tonic-clonic and absence seizures. Causes, diagnosis, treatment, triggers, classification, and first aid for different seizure types are outlined. The roles and responsibilities of healthcare staff in caring for people with epilepsy are also summarized.
Sleep disorders - a brief medical study martinshaji
A sleep disorder is any condition that involves difficulty experienced when sleep , such disorders involve daytime fatigue causing severe distress and impairment to work.
SD also have an impact upon social and personal functioning
this is a brief study on all aspects of this ...............
please comment
thank you
for any detailed suggestions and for any medical study materials connect with me
martinsuja369@gmail.com
than you
Sleep disorders - a brief medical study martinshaji
A sleep disorder is any condition that involves difficulty experienced when sleep , such disorders involve daytime fatigue causing severe distress and impairment to work.
SD also have an impact upon social and personal functioning
this is a brief study on all aspects of this ...............
please comment
thank you
for any detailed suggestions and for any medical study materials connect with me
martinsuja369@gmail.com
than you
It focuses on sleep medicine - sleep disorders, sleep stages, DSM classification, types, classifications, and pharmacological and non pharmacological management.
Epilepsy awareness training innovations slidesharePatrick Doyle
This Epilepsy Awareness training course is aimed at raising awareness of the importance of the safe care and management of epilepsy. The course explores some of the common misconceptions about epilepsy and to care for someone who experiences seizures. On completion of this course staff will be aware of the clinical features of epilepsy and contribute to the care and wellbeing of patients who experience epileptic seizures.
Duration: 2 hours
Experience: None required.
This course is suitable for all staff currently working within health and social care settings in the United Kingdom who may come into contact with patients who experience epileptic seizures.
Number of Trainees: 16 maximum
Course Standard: Certificate of attendance
Equipment Needed: Hand-outs will be provided
Candidates will cover:
•Definitions, diagnosis and symptoms of epilepsy, including the nature and incidence of epilepsy
•Seizures and seizure types
•Care and treatment of epilepsy, including basic first aid and emergency care
•What to do when caring for a patient experiencing an epileptic seizure
•Care and management of patients who experience epileptic seizures
•Living with epilepsy
By the end of the course Candidates will be able to:
•Describe the diagnosis, symptoms and different types of epilepsy
•Understand and demonstrate the care and treatment of patients with epilepsy
•Understand the impact of epileptic seizures
•Contribute to the care-planning and safe management and care of patients who experience epileptic seizures, including basic first aid for epileptic sufferers
It focuses on sleep medicine - sleep disorders, sleep stages, DSM classification, types, classifications, and pharmacological and non pharmacological management.
Epilepsy awareness training innovations slidesharePatrick Doyle
This Epilepsy Awareness training course is aimed at raising awareness of the importance of the safe care and management of epilepsy. The course explores some of the common misconceptions about epilepsy and to care for someone who experiences seizures. On completion of this course staff will be aware of the clinical features of epilepsy and contribute to the care and wellbeing of patients who experience epileptic seizures.
Duration: 2 hours
Experience: None required.
This course is suitable for all staff currently working within health and social care settings in the United Kingdom who may come into contact with patients who experience epileptic seizures.
Number of Trainees: 16 maximum
Course Standard: Certificate of attendance
Equipment Needed: Hand-outs will be provided
Candidates will cover:
•Definitions, diagnosis and symptoms of epilepsy, including the nature and incidence of epilepsy
•Seizures and seizure types
•Care and treatment of epilepsy, including basic first aid and emergency care
•What to do when caring for a patient experiencing an epileptic seizure
•Care and management of patients who experience epileptic seizures
•Living with epilepsy
By the end of the course Candidates will be able to:
•Describe the diagnosis, symptoms and different types of epilepsy
•Understand and demonstrate the care and treatment of patients with epilepsy
•Understand the impact of epileptic seizures
•Contribute to the care-planning and safe management and care of patients who experience epileptic seizures, including basic first aid for epileptic sufferers
THESE SLIDES ARE PREPAREED TO UNDERSTAND CHILD HEALTH DISORDERS IN EASY WAY Important links- NOTES- https://mynursingstudents.blogspot.com/ youtube channel https://www.youtube.com/c/MYSTUDENTSU... CHANEL PLAYLIST- ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list=PL93S13oM2gAPM3VTGVUXIeswKJ3XGaD2p COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPyslPNdIJoVjiXEDTVEDzs CHILD HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gANcslmv0DXg6BWmWN359Gvg FIRST AID- https://www.youtube.com/playlist?list=PL93S13oM2gAMvGqeqH2ZTklzFAZhOrvgP HCM- https://www.youtube.com/playlist?list=PL93S13oM2gAM7mZ1vZhQBHWbdLnLb-cH9 FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPFxu78NDLpGPaxEmK1fTao COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list=PL93S13oM2gAOWo4IwNjLU_LCuhRN0ZLeb ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list=PL93S13oM2gAPkI6LvfS8Zu1nm6mZi9FK6 MSN- https://www.youtube.com/playlist?list=PL93S13oM2gAOdyoHnDLAoR_o8M6ccqYBm HINDI ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAN4L-FJ3s_IEXgZCijGUA1A ENGLISH ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAMYv2a1hFcq4W1nBjTnRkHP facebook profile- https://www.facebook.com/suresh.kr.lrhs/ FACEBOOK PAGE- https://www.facebook.com/My-Student-S... facebook group NURSING NOTES- https://www.facebook.com/groups/24139... FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG – BLOGGER- https://mynursingstudents.blogspot.com/ Instagram- https://www.instagram.com/mystudentsu... Twitter- https://twitter.com/student_system?s=08 #PEM, #HEALTH,#NEW,#BORN,#ASSESSMENT, #APPEARENCE,#PULSE,#GRIMACE,#REFLEX,#RESPIRATION,#RESUSCITATION,#NEWBORN,#BABY,#VIRGINIA, #CHILD, #OXYGEN,#CYANOSIS,#OPTICNERVE, #SARACHNA,#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICER
the causes, pathophysiology, clinical manifestations, diagnosis and treatment of epilepsy has been discussed in detail with the perspective of a subject called pathophysiology in both medical sciences as well as the pharmaceutical sciences
Focuses on Epilepsy Management for poeple wth Tuberous Sclerosis. Includes information on:
- Status Epilepticus
- Epilepsy Management
- First Aid Principles
- Seizure Management Planning
Psychiatric emergency is a condition where in the patient has disturbances of thought, affect and psychomotor activity leading to a threat to his existence (suicide), or threat to the people in the environment (homicide).
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Learning Outcomes
Demonstrate an awareness of what Epilepsy
is and recognise different seizure types.
Understand appropriate First Aid
Understand the risks associated with
Epilepsy and the impact on a person’s
quality of life
Demonstrate an understanding of the role of
staff caring for a person with epilepsy.
3.
4. What is Epilepsy?
•
•
•
•
Epilepsy is a common, chronic neurological disorder
characterised by unprovoked seizures.
A seizure is caused by a sudden burst of excess electrical
activity in the brain, causing a temporary disruption to the
way the normal brain works.
The disruption results in the brain’s messages becoming
halted or mixed up.
What you experience during a seizure will depend on where
in your brain the epileptic activity begins and how rapidly it
spreads.
5. Epilepsy Facts
•
•
•
•
•
•
There are many different types of seizures (approx.40
different types) and unique to the individual.
It affects approx.112,000 young people under 25 in the
UK. 1: 250 children and 1: 100 adults.
It can affect anyone at any time.
It is not contagious.
There is no connection between epilepsy and
intelligence
Not all types of epilepsy are life long. Approx.75% of
children either outgrow their epilepsy or have their
epilepsy well controlled on medication
6. What causes Epilepsy
In 6 out of 10 cases there is no identifiable cause.
Those epilepsies with a known cause are called
‘symptomatic’. There are two main categories: those
caused by brain injury or disease e.g. Infections,
brain tumours, trauma, malformations or
degenerations, metabolic disorders.
Hereditary factors: Epilepsy can be inherited, but in
most people there is no family history of epilepsy.
Genetic testing can help identify specific Gene
defects, which may be useful for treatment,
prognosis and genetic counselling.
7. Diagnosis
There is no single test that will tell the consultant
whether a person has epilepsy or not.
A diagnosis is based on the medical history and eye
witness account of the event.
Various other tests such as an EEG, MRI, blood
and genetic testing, may help to identify the type of
epilepsy and possible cause.
8. Treatment
•
•
•
•
The medicines used are called Antiepileptic drugs
(AED).
Epilepsy is usually controlled, but not cured by
medication.
Up to 70% of people can become seizure free if they are
on the most appropriate medication for them.
Taken on a regular basis
Usually twice daily
Common side effects include tiredness, dizziness and
nausea.
Other treatments options are ketogenic diet, VNS (Vagal
Nerve Stimulator) or surgery.
9. Potential Triggers
o
Missed or late medication
o
Lack of sleep/tiredness
o
Stress /Excitement
o
High Temperature
o
Menstruation/ puberty
o
Alcohol/drug
o
Flickering lights/photosensitivity
•
12. Focal (partial) seizures
Affects just one part of the brain
The person can be fully aware but may experience a
strange sensation e.g.. Funny feeling in their tummy,
strange taste, smell or fear. The person may also
experience twitching of a finger/ face or have
numbness.
OR
Consciousness may be altered and the person looks
confused. May make strange movements e.g. Lip
smacking, chewing, rubbing, plucking at their clothes
Discharges can spread to the rest of the brain
resulting in a generalised tonic-clonic seizure.
13. First Aid
Focal Seizures
Involving Altered Consciousness or Behaviour
•
•
•
•
•
•
DO
Keep Calm
Guide the person from
danger
Stay with the person until
fully recovered
Talk quietly to reassure
them
Repeat anything they have
missed
Record time & length of
episode
•
•
•
•
•
DON’T
Restrain the person
Act in a way that could
frighten the person such as
making abrupt movements
or shouting at them
Assume the person is
aware of what is happening
Attempt to bring the person
around
Give the person anything to
eat or drink until fully
recovered
14. Generalised Seizures
In Generalised seizures the epileptic activity is in
both halves of your brain.
The main types of Generalised seizures are:
• Tonic Clonic
• Absence
• Myoclonic
• Tonic
• Atonic
15. Generalised Seizures
Absence seizures
•Generally a childhood disorder
•The child may look blank and stare, lasting a few
seconds
•Child can appear to be day dreaming or dazed
•Eyelid fluttering/ blinking may occur
•May have minor facial movements or head drop
•Able to continue normal activity almost immediately
afterwards
16. Generalised Seizures
•
•
•
Myoclonic: - The person has shock like
contractions of different muscles. These are brief
but can happen in clusters and often occur shortly
after wakening
Atonic (drop attack): - Sudden loss of muscle tone
and person falls to the ground. Lasts a few seconds
and able to continue normal activity immediately
afterwards
Tonic:- The person’s muscles contract resulting in a
fall. These are all very brief and recover quickly but
the person may injure themselves as a result of
these.
17. Tonic-Clonic Seizures
Most common and widely recognised of the generalised
seizures. Resulting in loss of consciousness.
Tonic Phase
•Muscles contract, body stiffens and person falls to the
ground
•The person may become pale
•Their breathing may be irregular and lips may appear
blue
•Saliva may dribble from their mouth and can be blood
stained if tongue has been bitten
•Incontinence may occur
18. Tonic-Clonic Seizures
Clonic Phase
•Consists of short sharp rhythmical jerks and gradually
slows down
•Muscles relax and the body becomes limp
•The person will slowly regain consciousness but may
be groggy and confused afterwards
Post-ictal state
•After the seizure the person can be very tired and have
memory loss. This can last from minutes to days.
19. First Aid
Tonic Clonic Seizures
DO
•
•
•
•
•
•
Keep Calm and reassure
the person
Protect them from injury –
remove harmful objects
Cushion their head
Aid breathing by gently
placing the person in the
recovery position when the
seizure has stopped
Record time & duration of
seizure
Stay with the person until
fully recovered
•
•
•
•
•
DON’T
Put anything in the
person’s mouth
Move unless in danger
Restrain the person
Give anything to eat or
drink until fully
recovered
Attempt to bring the
person around
22. Call an Ambulance if ……
•
•
•
•
The seizure continues for more than 5mins or
longer than is normal for the person.
One seizure follows another without the person
regaining consciousness
Person is injured during the seizure
You believe the person needs urgent medical
assistance
23. Emergency Medication
(Buccal Midazolam, Rectal Diazepam or Paraldehyde)
•
•
•
•
•
On rare occasions emergency medication is needed
to stop continuous or repeated seizures.
This is to help prevent status epilepticus which is
a medical emergency.
Emergency medication should only be given by
someone who is trained in this procedure and
where consent has been obtained.
If required, an Epilepsy Emergency Medication Plan
(EEMP) will be completed by the Consultant.
In addition to this, an individualised care plan will
also be completed by the identified named nurse.
In the absence of an up to date EEMP or
appropriately trained staff, an ambulance must be
called.
24. Epilepsy and Risk Assessment
•Risk involves balancing the health and safety
of the individual with not wishing to restrict their
quality of life by being over protective.
•It should be a multi disciplinary process
•Often a complex task and specific to each
individual.
25. Risks with Epilepsy
•
•
•
•
Stigma and quality of life- over protected
versus informed choice and consent
Risks of injury and fractures, increased
admissions to hospital.
Medication side effects.
SUDEP- Sudden unexpected death in
Epilepsy.
26. Practical Safety Tips
Ensure family/ friends/ colleagues/ carers know
about your Epilepsy and first aid care.
Attend all Epilepsy appointments with Nurse or
Doctor.
Take prescribed medication as directed.
Shower rather than bath.
Inform people of your schedule/ routine.
Wear Medic Alert bracelet / necklace.
Most sporting activities are suitable with care
27. Role Of Staff
Obtain information about the person’s epilepsy
from individual, family/ carer.
Communicate with person and family about any
concerns i.e. seizure pattern, change in ability,
behaviour or mood.
Report & record any seizure activity observed as
per local policy. Communicate with appropriate
staff/ carers.
Ensure mandatory first aid training is up to date.
Ensure a risk assessment is carried out for the
individual if required.
28. Information Required About
Person’s Epilepsy
•
•
•
•
Emergency contact details
Type of seizure/s
Any warning or tell tale signs of a pending seizure
What happens
•
•
•
Before a seizure
During a seizure
After a seizure
How long does the seizure last
How person is following a seizure and what First Aid
is appropriate.
Details of emergency medication if required.
29. Living with Epilepsy
•
•
•
Many fears and myths about Epilepsy are due to a
lack of knowledge.
By finding out about the person’s epilepsy you will
have a better understanding of how you can help.
Children and adults should be encouraged to
actively participate in the same activities as their
peers, where possible promoting independence,
confidence and self esteem.
What is Epilepsy?
Epilepsy is a tendency to have recurrent seizures, sometimes called fits, convulsions. Having one seizure does not usually mean that a child has epilepsy. A seizure occurs when the electrical signals which travel along and between the nerve cells in the brain are sent out of order. Because these nerve cells control everything the body does, a seizure can take a number of different forms.
It is a common condition affecting 1:242 School Age Children (Epilepsy Action 2005) and is more common in children with learning disability, approximately 22% of people with learning disability have epilepsy.
Important Points
Epilepsy is the most common sever neurological disorder in the world. it is a medical & social diagnosis affecting every aspect of a persons life. People can die as a result of a seizure.
Some people still have a primitive view of epilepsy. As recently as 1978 two priests in Switzerland were asked to perform an exorcism on a 22 year old woman with epilepsy whose family thought she was possessed by the devil. Most people only have a vague idea of what it means to have epilepsy even though it is one of the three most common chronic conditions, the others being asthma & diabetes. In some cases there remains a stigma attached to the diagnosis of epilepsy.
Most people when they hear “Epilepsy” think of tonic clonic seizures previously known as “grand mal seizures” and also associate epilepsy with people who have learning disability these are both untrue.
There are approximately 40 different types of seizures some of which will be discussed later on.
Epilepsy can develop at any age, however it is most often diagnosed before the age of 20 and after the age of 60.Each persons seizures will be very individual/specific to the person which is why it is important to have individual action plans for each child with epilepsy.
Statistics from Epilepsy Action 2005
Epilepsy can be inherited, but in most people there is no family history of epilepsy. In the majority of people, inheritance only plays a limited role and this is especially true of partial seizures. It is thought that contributions made by the father and the mother in relation to the inheritance of epilepsy are of equal importance. Genetic testing is helpful in identifying specific gene defects and thus ensuring appropriate diagnosis, treatment regimes, prognosis and genetic counselling. Some genetic epilepsies include epilepsy with febrile seizure plus, JME, Dravet Syndrome and Ohtahara syndrome.
Following a seizure the person may attend their G.P or Accident Emergency Department.. If there is suspicion of epilepsy, the National Institute for clinical excellence( NICE) guidelines state the person should be referred to a specialist. This specialist is likely to be a Consultant Neurologist, or a Consultant Paediatrician who has a specialist interest in epilepsy. There are 3 key questions that they will be looking to answer. Was the event an epileptic seizure? If so, what type of seizure occurred?. Does your child have an epilepsy syndrome. Eyewitness account to include information on what was happening prior to event, during and after the event. Refer to Young Epilepsy seizure description form.
Treatment
The usual way of treating epilepsy is with medication. The aim of the treatment is to control the epilepsy and reduce or prevent seizures occurring. Approximately 70% of people taking anti – epileptic drugs (AED) can expect to heave their seizures greatly reduced. If a person is seizure free for two years the doctor will discuss the option of coming off medication which is then done gradually.
Medication
The choice of medication will depend on the individual’s type of seizure and the type of epilepsy they experience. Medication must be taken regularly, it is usually prescribed twice a day and therefore not normally required in school hours, it should never be stopped abruptly as this could trigger a seizure. Medication may cause drowsiness, memory problems and difficulty concentrating. It is important to balance effect with side effect.
With the correct medication and dosage many people are able to remain seizure free.
Ketogenic Diet- high fat low carbohydrate diet, needs supervised by specialist dietician and neurologist.
VNS- it is a small device like a pacemaker) surgically implanted into the right upper chest area. It stimulates the vagus nerve and provides an anti epileptic effect.
Potential Triggers
Triggers are stimuli which may cause a seizure at a particular time. These are different for everyone, triggers include flickering or flashing lights although this affects only 5% of people with epilepsy. It is important for individuals to recognise their own triggers and try to avoid these or make changes to their lifestyle to help minimise these risks e.g. taking medication before going out if late home and try to catch up on sleep the following day.
ILAE
First Aid
Partial/Focal Seizures
In this type of seizure consciousness or behaviour is altered, do not try to stop the seizure
Do
Guide the child from danger
Stay with the child until fully recovered
Talk quietly to reassure the child
Repeat anything they have missed
Record time & length of attack – observe for any other seizures
Remain with child until recovery is complete
DO NOT
Restrain the child – ensure the child can’t injure themselves, remove any harmful objects
Act in a way that could frighten the child such as making abrupt movements or shouting at them
Assume the child is aware of what is happening or what has happened
Give the child anything to eat or drink until fully recovered – their consciousness is altered so the may have difficulty swallowing, you must ensure the child is fully recovered before they are offered anything to eat or drink
Attempt to bring the child around – the seizure will stop in its own time
First Aid Seizures Involving Loss of Consciousness
In this type of seizure consciousness is lostDo
Keep Calm
Protect the child from injury – remove harmful objects from nearby
Cushion head
Place in the recovery position as soon as possible
Record length of seizure
Remain with child until recovery is complete
Reassure child following seizure
DO NOT
Put anything in the child’s mouth
Move unless in danger, only move the child if they are in danger, their head should be supported if they are in a chair and they should be placed in the recovery position as soon as possible following the seizure.
Restrain the child
Give anything to eat or drink until fully recovered
Attempt to bring the child around
This slide demonstrates the recovery position
Status epilepticus is when any seizure lasts for or at least 30 minutes or repeated seizures lasting for a total of 30mins or longer, from which the person does not regain consciousness between each seizure. It is a medical emergency and in rare cases can be life threatening. To prevent this from happening it is important to follow the persons emergency management plan and administer emergency medication or call an ambulance if the seizure or cluster lasts longer than 5 minutes.
Medication side effects ranging from rashes, increase/ decrease in appetite, mood changes, blood problems, memory and concentration problems, depression. Depends on medications used, how many epilepsy medications used and the age and personality of the person with epilepsy.
SUDEP- this is a situation where a person has epilepsy and may have a seizure resulting in an associated Cardio- Respiratory arrest leading to a sudden death. Although it is rare, (1 in 400 people with epilepsy) it is being increasingly recognised as a risk in Epilepsy and it is risk related to inadequate control of tonic clonic seizures. High risk patients are those with complex health needs, those who take nocturnal seizures, are on multiple medications, live alone and don’t have a balanced lifestyle.
Ways to minimise/ reduce this risk -Ensure the correct diagnosis and type of epilepsy. Ensure correct type and dose of medication is given for epilepsy. Individual should be under the care of a specialist if seizures are not controlled and should attend clinic appointments regularly. Try to get as best seizure control as possible. Ensure someone is available to keep an eye on the person who has epilepsy. Healthy lifestyle advisable- adequate sleep, moderate alcohol intake and avoid any recreational drugs. Refer to sudep.org website
Maintain good links with your Epilepsy Nurse or doctor to discuss any concerns with epilepsy and medication. Do not stop medication abruptly at any time without medical advice.
Can drown in bath.
Medical Alert bracelet has information about your condition, and who to contact and what to do.
People do not have to be told about your epilepsy but if seizures are not well controlled it is safer if other people know what to do and helps to prevent unnecessary admissions to hospital or people putting spoons into your mouth!
Assess each sport individually. Some activities generally not advised are boxing and mountain climbing.
Role of Staff
As previously stated it is important to have as much information about the seizures and their effect on the person including side effects of medication.
If staff notice any unusual behaviour or have concerns they should liaise with the individual parent/carer as medication may need to be reviewed, new triggers may have been identified which require avoidance.
School staff often are first to notice and report to parents/ carers any changes.
Information from Parent/Carer
As every child will have different seizure patterns it is important that school staff have as much information about each child’s individual seizure pattern. Each child with epilepsy will have an epilepsy care plan which details
The type of seizure
Warning signs – some children will get an “aura” or warning, this could be feelings of fear or an unusual taste or smell
What happens
Before a seizure
During a seizure
After a seizure
Duration of the seizure, most seizures last approximately 2 minutes again this will be individual for each child, when observing a seizure two minutes is a very long time!!!
Behaviour following a seizure
Emergency response for the child
Details of emergency medication if required
Contact numbers for parents/carers – these numbers should be people who are within easy access of the school and not Granny who lives in Coleraine!