Epilepsy awareness training innovations slideshare

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

1. Epilepsy Awareness July 2015 Tutor: Patrick Doyle © Training Innovations Ltd 2015 Last updated: 17.07.15

2. Learning Outcomes Demonstrate an awareness of what Epilepsy is and recognition of different seizure types Be able to support patients’ experiencing seizures, ensuring their safety and dignity Demonstrate awareness of the importance in observing and recording seizure activity Recognise possible trigger factors

3. Learning Outcomes Demonstrate an understanding of the epilepsy/emergency management plan Raise awareness of the impact of epilepsy on a patient's life Understand the need for balancing risk and achieving a quality of life Raise awareness of the possible educational implications of the condition

4. What is Epilepsy? Epilepsy has been defined as a tendency to have recurrent seizures Also referred to as “fits”, “convulsions” etc. The chemical balance in the brain is upset and there is abnormal firing of nerve cells One seizure does not constitute epilepsy Common condition Affects 1:242 School Age Children (Epilepsy Action 2005 ) More common in patients with learning disability Approximately 22% of people with learning disability have epilepsy

5. Important Points Common serious /chronic condition Approximately 40 different types of seizures Can develop at any age, however it is diagnosed most before the age of 20 and after the age of 60 Very individual/specific to the person

6. SUDEP (sudden unexpected death in epilepsy) Sudden death with no obvious cause Can occur with/without evidence of a seizure It is estimated that approx 1 per 1000 people with epilepsy in the UK die as a result

7. What causes Epilepsy 60 - 70% of cases the cause is unknown Some known causes include Birth injury Head injury Stroke Brain haemorrhage Brain Tumour Meningitis/encephalitis Drugs Alcohol

8. Potential Triggers Flickering lights/photosensitivity Lack of sleep/tiredness Stress Excitement Missed meals High Temperature Menstruation Missed or late medication

9. Classification of Seizures Seizures can be divided into two main groups Groups: Generalised Seizures Focal/ Partial Seizures

10. Generalised Seizure Types Tonic-Clonic Typical Absence Atonic Tonic Myoclonic

11. Tonic -Clonic Seizures Most common of the generalised seizure May have an aura leading into the tonic/ clonic seizure Lose consciousness Usual duration 1-2 minutes May follow on from a focal seizure

12. Tonic Phase Muscles contract, body stiffens and patient falls to the ground The patient may become pale Their breathing may be irregular and around their lips may appear blue Saliva may dribble from mouth and can be blood stained if tongue has been bitten Incontinence may occur

13. Clonic Phase Consists of short sharp rhythmic jerks caused by alternate contraction and relaxation of muscles in the trunk and limbs Periods of relaxation become more frequent and prolonged Muscles relax and the body goes limp. At this stage the patient will still be unconscious Slowly they will regain consciousness, but may be groggy and confused

14. Management of Tonic-Clonic Seizures DO: Stay calm Assess danger to patient- move if in danger Protect their head Loosen tight clothing, remove glasses

15. Management of Tonic-Clonic Seizures DO Time seizure/observe and record Once seizure has finished aid breathing by gently placing them in the recovery position Stay with the patient until recovery is complete Reassure and re-orientate the patient, tell them they have had a seizure

16. Management of Tonic-Clonic Seizures DO Allow the patient a period of rest /sleep afterwards if required

17. Management of Tonic-Clonic Seizures DON’T: Try to restrain or restrict the patient's movements Put anything into their mouth* Give the patient anything to eat or drink until they are fully recovered

18. Typical Absence Seizures Generally a childhood disorder May look blank and stare, lasting a few seconds Eye lid fluttering/blinking may occur May have minor facial movements or head drop Able to continue normal activity almost immediately

19. Management of Absence Seizures DO Record the time of day and frequency Reassure if necessary Repeat information that the patient may have missed

20. Atonic Seizures (drop attack) Sudden loss of muscle tone Fall heavily to the ground Lasts only a few seconds Able to continue normal activity almost immediately

21. Tonic Seizures Muscles contract Body stiffens- trunk, facial muscles and limbs Results in falls Quick recovery

22. Management of Atonic and Tonic Seizures Check for injuries which may need medical attention Stay with the patient and reassure

23. Myoclonic Seizures Quick muscle jerks usually of limbs however head and shoulders may jerk forward May be one or both sided Usually seen in specific patienthood epilepsy syndromes Frequent soon after waking Short lived so difficult to tell if consciousness is impaired

24. Management of Myoclonic Seizures May be unsteady and if they fall check for injuries Stay with the patient until they recover Reassure

25. Focal/ Partial Seizures Abnormal discharge confined to part of one cerebral hemisphere Can spread to the rest of the brain resulting in a secondary generalised seizure Consciousness may or may not be impaired Symptoms depend on the area of the brain involved e.g. hearing, vision, smell or taste

26. Focal/Partial Seizures Symptoms can last from seconds to 1 – 3 minutes can present as: mumbling or uncontrolled laughter Sucking, chewing or swallowing movements Plucking at or removing clothing May wander around as if drunk

27. Management of Focal Seizures DO Stay calm Guide the patient from danger Stay with the patient until recovery is complete Reassure and explain anything they have missed

28. Management of Focal Seizures DON’T Restrain the patient Act in a way that could frighten them, such as making abrupt movements or shouting at them Give the patient anything to eat or drink until they are fully recovered

29. Call an Ambulance if …… You think the patient needs urgent medical assistance The patient has any breathing difficulties following a seizure It is a first seizure The seizure continues for longer than normal One seizure follows another without regaining consciousness

30. Following a Seizure After a seizure the patient may be….. Confused Have no memory of what has occurred Subdued Tired & sleepy Have a headache Concentration impaired Hyperactivity

31. Care following a Seizure Clear understanding of what has occurred Observe: Breathing & colour Any injuries Be aware of post-ictal state Offer support and counselling as appropriate

32. Seizure Management Plan Seizure Management Plan should be in place & available agreed by: Parent/carer Doctor patient’s Epilepsy Nurse Specialist Original Copy to travel with the patient (Epilepsy Passport) Updated yearly or more often if required Be aware of who is responsible for first aid Parent/carer should be informed of seizure ASAP Record seizure

33. Seizure Management Plan WILL PROVIDE: Description of seizure Usual duration of seizure Trigger factors Management of seizure

34. Emergency Seizure Management Plan WILL PROVIDE: Description of seizure/duration Indications for use of emergency medication inc. Buccal Midazolam Initial dose of emergency medication Usual response to emergency medication

35. Emergency Seizure Management Plan WILL PROVIDE Who is trained to administer Consent

36. Observable Implications A change in behaviour can be observed: Seizure activity Side effects of medication Memory: Can experience some loss or difficulty retaining information

37. Role of Staff/Carer Be aware of patients’ with epilepsy Have as much information as possible about specific seizures from parent/carer Observe any unusual behaviour & liaise with parent/carer Staff may be first to pick up on the seizure Absences/day dreaming

38. Role of Staff/Carer Positive attitude to condition Avoid treating condition as an illness Recognise/record changes in mood/behaviour/social interaction Risk assess for particular activities

39. Role of Staff/ Carer Observe and record details of seizures Promote communication with parents Minimise embarrassment

40. Care of other Patients Reassure other patients present The type of seizure they witness will have a direct impact on how they cope Do not keep epilepsy a secret

41. Activity Most patients with epilepsy should be able to fully participate in most activities ensuring adequate supervision is provided Each activity & each patient should be considered individually Special considerations & precautions should be discussed with the parent

42. Social Life The following increase the risk of seizures Excess alcohol Lack of sleep Disturbed sleep patterns Missing meals Forgetting to take medication Recreational drugs

43. Points to Remember Normally seizures run their course and the patient recovers without need for medical intervention. patients should be given the opportunity to participate in the same activities as their peers do promoting independence, confidence and self-esteem.

44. Any questions? Please take some time to complete the course evaluation - Thank you… PowerPoint slides available at: www.slideshare.net/TInnovations [email protected] www.traininginnovtions.co.uk Twitter: @ Traininnovate Facebook : https://facebook.com/pages/Training-Innovations-Ltd