Diastat Training Module Natomas Unified School District
Transcript
Slide 1
Diastat Training Module Natomas Unified School District
Slide 2
Objectives Upon completion of the Seizure/Diastat training you
will demonstrate and/or verbalize: Recognition and treatment of
different types of seizures Administration of an emergency
anti-seizure medication Management of seizures in the school
setting based upon the physicians orders and seizure medication
authorization
Slide 3
Objectives Continued Safe and correct management of pupil
requiring Diastat during a seizure. Basic emergency follow-up
procedures Techniques and procedures to ensure pupil privacy Record
keeping requirements
Slide 4
Pre-Test Take Pre-test Answers will be reviewed at the end of
the presentation.
Slide 5
Procedure for Diastat at School Parent request/consent for
Emergency Anti- seizure medication. Physician authorization for
Emergency Anti- seizure medication. Seizure Emergency Action Plan
completed by doctor. Electronic request for volunteers is sent out.
Volunteer must have current CPR. Agreement to administer Diastat is
voluntary.
Slide 6
Continued Volunteer must complete training before giving
medication. Documentation of completed training must be retained in
volunteers personnel file. Volunteer may rescind offer to
administer Diastat up to three days after training. After that
time, volunteer may rescind offer to administer with a two week
notice. Volunteering to administer Diastat is student
specific.
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Continued Volunteer must report every administration of Diastat
to the School Administrator and the District Nurse. Retraining is
required every yearly. Periodic review with volunteer can be done
by the district nurse throughout the school year.
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What is Diastat? Diastat is a gel form of Diazepam Used for
emergency seizure situations Anti-seizure medication
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Mechanism of Diastat Action Diazepam belongs to a class of
medications called benzodiazepines which produce a calming effect
on the brain and nerves (central nervous system). It is thought to
work by increasing the effect of a certain natural chemical (GABA)
in the brain.
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Types of Seizures requiring Diastat There are two types of
seizure emergencies: Status Epilepticus a prolonged clonic-tonic
seizure lasting for an extended period of time. This period of time
is determined by the students physician. For some it is 5 minutes
for others it is less and some more. Acute Repetitive Seizure a
series of seizures or cluster seizures, each lasting a short period
of time. In between seizures, the student regains
consciousness.
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Indicators for Diastat administration This medication is used
to treat episodes of increased seizures (e.g., acute repetitive
seizures, breakthrough seizures) in people who are already taking
medications to control their seizures. This product is only
recommended for short-term treatment of seizure attacks. It is not
for ongoing daily use to prevent seizures. Uncontrolled seizures
can turn into serious (possibly fatal) seizures that do not stop
(status epilepticus).
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Side Effects of Diastat Mild side effects might be:
Drowsiness/sleepiness Dizziness Diarrhea Unsteadiness
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Side Effects of Diastat More severe side effects might be:
Slow/shallow/difficult breathing Mental/mood changes (e.g.,
anxiety, restlessness, hallucinations, sleep problems) Slurred
speech Trouble walking.
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Allergic Reaction to Diastat Symptoms include: Rash
itching/swelling (especially of the face tongue/throat) dizziness
trouble breathing
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Contraindications Diazepam is contraindicated in patients with
a known: Known hypersensitivity to this drug. If Diastat has been
given within 4 hours prior at home. Because of lack of sufficient
clinical experience, in children under 2 years of age.
Contraindicated in acute narrow angle glaucoma.
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Standard Procedure for Administering Diastat 1. Time the
seizure and get ready to administer the Diastat. 2. If orders state
that Diastat is to be given immediately proceed to the following
steps below. 3. Have someone call 9-1-1 4. Place the student on
their side, where they cannot fall. 5. Get the medication or have
someone get it from the locked area and bag with blanket..etc.
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Standard Procedure for Administering Diastat 6. Get the syringe
out 7. Push up with your thumb and pull to remove the cap fromthe
syringe (Be sure seal pin is removed with the cap) 8. Lubricate
rectal tip with lubricating jelly. Turn student on the side facing
you. Bend their upper leg forward to expose rectum. Separate
buttocks to expose rectum.
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Standard Procedure for Administering Diastat 12. Gently insert
syringe tip into rectum. (Rim of syringe should be snug against
rectal opening) SLOWLY count to 3 while gently pushing plunger in
until it stops. 14. SLOWLY count to 3 before removing syringe from
rectum. 15. SLOWLY count to 3 while holding buttocks together to
prevent leakage. 16. Keep student on the side facing you, note time
given and continue to observe.
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Follow-up and Observations After Administering Diastat Watch
breathing pattern of student Begin CPR if student stops breathing
or as needed. Continue to observe Remain with the student. Never
leave a student having a seizure unattended. Continue to time the
seizure until it has stopped Never put anything in the mouth of
someone having a seizure.
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Pupil Privacy Request another staff member move other pupils
away from area. Have someone get the emergency treatment packet for
the student (which should be kept in a private place for
confidentiality). Have a bag which contains a blanket or other
appropriate article to be used to cover pupil and avoid exposure
and a small item like a jacket to place under the head (provided by
parent).
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Documentation and Records Complete Seizure Log and Seizure
Incident Report. This documentation includes: Pupil name Name of
medication Dose Date Time given Length of seizure Observation
Status of pupil Action taken after seizure Provide copy to school
nurse.
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Emergency Care Plans Chain of responsibility regarding Diastat
administration in the school setting, i.e., Physician (Doctors
orders) Parent (request for unlicensed personnel to administer
Diastat) Administration (sending out email to request volunteers)
Trainer of volunteer (District Nurse) Volunteer (Teacher,
secretary, aide, principal) EMS/911. Review the pupils Seizure
Emergency Action Plan (this is only for the personnel directly
responsible for delivering the emergency care).
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Video
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Review Questions Review: Seizure log Facts for school personnel
Seizure Emergency Action Plan Physicians Authorization Practice
scenarios on Nickie Training Doll Take Post-test Go through
checklist
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References
https://healthy.kaiserpermanente.org/health/care/consume
r/health-wellness/drugs-and-natural-medicines
https://www.epilepsy.com
http://www.druginformation.com/RxDrugs/D/Diazepam
%20Rectal%20Gel.html
http://www.druginformation.com/RxDrugs/D/Diazepam
%20Rectal%20Gel.html California School Nurses Organization. (2012).
http://www.csno.org/diastat-issues/
http://www.csno.org/diastat-issues/
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Resources Epilepsy Foundation Northern California 155
Montgomery Street Suite 309, San Francisco, California 94104-4108.
Phone: (415) 677-4011Toll Free: (800) 632-3532.
http://www.epilepsy.comhttp://www.epilepsy.com Diastat AcuDial
Epilepsy & Seizure Resource Center. Back To School.
http://www.diastat.com/resource-
center#schoolhttp://www.diastat.com/resource- center#school WebMD
http://www.webmd.com/drugs/drug-94251-
Diastat+AcuDial+Rect.aspx?drugid=94251&drugname
=Diastat+AcuDial+Recthttp://www.webmd.com/drugs/drug-94251-
Diastat+AcuDial+Rect.aspx?drugid=94251&drugname
=Diastat+AcuDial+Rect