title: Are we failing to provide adequate rescue medication to children at risk of prolonged convulsive seizures in schools?
abstract: OBJECTIVE
  This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK.
  Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally.
  
  
  CONCLUSIONS
  A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan.
  
  
  CONCLUSIONS
  Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall.
authors.affiliation: UCL Institute of Child Health, Great Ormond Street Hospital NHS Foundation Trust, , London, UK.
authors.forename: J Helen
authors.initials: JH
authors.lastname: Cross
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wait
authors.forename: Alexis
authors.initials: A
authors.lastname: Arzimanoglou
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
authors.forename: Christine
authors.initials: C
authors.lastname: Bennett
authors.forename: Lieven
authors.initials: L
authors.lastname: Lagae
authors.forename: Janet
authors.initials: J
authors.lastname: Mifsud
authors.forename: Dieter
authors.initials: D
authors.lastname: Schmidt
authors.forename: Gordon
authors.initials: G
authors.lastname: Harvey
mesh_terms: D002648:Child; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D006801:Humans; D012306:Risk; D012572:School Health Services; D012574:Schools; D012640:Seizures / Q000188:drug therapy*; D013222:State Medicine; D006113:United Kingdom
keywords: Medical Education; Neurology; School Health; rescue medication; seizures
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