MANAGING CHILDREN WITH EPILEPSY


Looking after for children with seizures is usually no different from looking after other children. Unless parents have said otherwise, a child with epilepsy should be treated like any other normal, active youngster.
But a responsible carer always stays alert, is always aware of some special things to watch for, and knows exactly what to do if a child has a seizure.

About Epilepsy
A seizure or fit is caused by a brief electrical disturbance in the child's brain. Any child can have a seizure from injury or illness, which is why everyone who looks after children should be seizure smart.
When a child has a history of having seizures from fever, or has been diagnosed with epilepsy, it just means that he or she is more likely to have a seizure than other children are.
No one can see the electrical disturbance in the brain that is causing the seizure. But you may see the brief changes it causes in how the child acts or feels.

What Seizures Look Like
One kind of seizure can make a child stop what he/she is doing and stare for a few seconds. Another kind can make him or her fall suddenly to the ground.
A seizure may make an arm or leg shake for a minute or two, or make the whole body jerk. Or it can make the child feel afraid or angry or make things look differently from what they really are. A seizure can make a child seem confused and dazed, as if half asleep and not in touch with what's going on around him/her.
Another kind could make a child have a convulsion, the kind of seizure that most people think of when they hear the word "epilepsy." This type of seizure makes a child cry out, black out, fall, get stiff and then shake for a minute or two.

Both Different and Alike
Seizures look so different because they affect different parts of the brain. But they are alike in several ways, too.
They usually don't last long.
In most cases you don't have to do anything to stop them. They stop on their own. They're unlikely to be medical emergencies.
Most don't require any first aid - just watchful waiting till the seizure stops. And when first aid is needed, it's mostly to keep the child safe until the seizure is over.

Good News
Most children with epilepsy today don't have seizures very often.
That's because children with epilepsy take medicine to prevent seizures. Or, they may be on a special diet or have an implanted device that makes seizures less likely.

Keeping Children Safe
If treatment controls their seizures completely, most children can live normal, active lives with few restrictions.
But if a child is still having some seizures, how do you know what are reasonable and safe activities for him?
First, you ask the parents and write down any special instructions they may have. If there are no special rules, treat a child with epilepsy just as you would any other child in your care, but be extra watchful if he or she is playing in or near water or high places.
You'll need to know what the medicine looks like, how much to give, and how it should be given.
If the child is on a special diet for epilepsy, you will want to make sure nobody gives him or her anything that has not been already prepared by the parents.

Simple First Aid
While you may never have to manage a seizure in a child with epilepsy, knowing what to do - being a Seizure Smart carer - can make a big difference if a seizure does occur.
In most cases, all you need to do is a few very simple things to keep the child safe until the seizure ends on its own.
Sometimes, you don't have to do much or anything at all.
Little staring spells last only a few seconds and then the child goes back to what he was doing before. He or she may not even know a seizure happened.
If a child jerks or falls suddenly because of a seizure, all you have to do is help the child up, see if the child is hurt, and comfort him/her if the child is upset.
If a child seems dazed and confused and wanders around looking half asleep, stay and talk to him/her quietly and calmly. Guide the child gently away from anything that could hurt him/her (like stairs, a stove, or a hot heater). Comfort the child as he or she slowly comes out of it.
If a child suddenly cries out, falls, stiffens and shakes, you still don't have to do much. A few simple steps will keep him or her safe for the minute or two the seizure usually lasts.

• First, clear everything out of the way.
• Don't hold the child down or try to stop the jerking.
• Put something flat and soft under the child's head.
• Make sure there's nothing tight round his neck that could interfere with breathing.
• Check your watch so you'll know how long the seizure lasts.
• Turn the child gently onto one side so he or she doesn't choke.
• Don't try to open his or her mouth.
• Don't try to put anything in his or her mouth.
• Don't try to give him or her anything to drink during the seizure.
• Comfort the child as he or she starts to wake up afterwards. Help the child get cleaned up if the child has wet or soiled him/herself during the seizure.

Some children are exhausted after a seizure like this and need to sleep. Some are confused or cranky for a while. Others can go back quite quickly to what they were doing before. The parents will tell you what to expect.

Emergency Aid
Should you call the rescue squad if a child has a seizure, in which he falls and shakes?
Yes, if the parents have asked you to call.
No, if the seizure ends without any problems and the child is back to normal afterwards.
The average seizure in a child who has epilepsy is not a medical emergency. It ends naturally by itself. But every rule has an exception or two, and that's true of epilepsy as well.

There are a few times, fortunately quite rare, when you should call for emergency medical assistance.

• When a seizure doesn't show any signs of stopping after five minutes.
  
• When the seizure happened in water and there's any chance that the child inhaled or swallowed a lot of water.
  
• When a child doesn't come round or isn't breathing properly afterwards.
  
• When a child vomits during the seizure and then doesn't come round or isn't breathing properly afterwards
  
• When another seizure starts soon after the first one.
  
• When an unexpected seizure happens in a child who does not have epilepsy.

If a child has prolonged seizures (longer than 5 minutes) or has clusters of seizures, the doctor may have prescribed some special medicine that can be given. However, that is something that the parents will discuss with you, and you will need training in how to apply it.

Tips to Remember

• The average child with epilepsy is healthy and wants to be treated just like any other child.
• A child with epilepsy should get his or her medicine on time.
• It's nobody's fault if a child has a seizure. It's not the child's fault or your fault.
• Most seizures are not emergencies and do not need emergency care.
• Talk things over with parents so you know exactly how they want you to handle a seizure.
• Unless you have other instructions, first aid for seizures is mostly to keep the child safe until the seizure ends naturally.
• If a child has a convulsion, turn him or her on one side to prevent choking.
• Having a seizure is upsetting and embarrassing for a child. He or she will need comforting and kindness afterwards.
• Call for emergency assistance if a seizure lasts longer than 5 minutes, if another seizure starts, or if the child doesn't wake up or breathe properly afterwards.
• A child with epilepsy probably won't have a seizure while you're looking after him.

Always consult with a doctor