Epilepsy in schools how to deal with a tonic clonic seizure

Epilepsy in Schools: Managing a Tonic-Clonic Seizure

A tonic–clonic seizure has two phases:

Tonic phase: sudden stiffening, fall to ground.

Clonic phase: rhythmic jerking of limbs.

It usually lasts 1–3 minutes.

✅ What School Staff Must Do (Step-by-Step)
1️⃣ Stay Calm & Ensure Safety

Keep students away; create space around the child.

Gently guide them to the floor if they are still standing.

Remove nearby hard or sharp objects (furniture, school bags, sports equipment).

Loosen tight clothing around the neck (tie, collar).

2️⃣ Protect the Head

Place something soft under the head:
folded jacket, bag, sweater.

Turn the head slightly to the side if possible.

3️⃣ Time the Seizure

Use a phone/watch — duration is medically important.

Normal duration: < 3 minutes.

❌ Do NOT Do These

❌ Do NOT restrain the student’s movements.

❌ Do NOT put anything in their mouth — no spoon, finger, cloth.

❌ Do NOT give water, food or medicine during the seizure.

❌ Do NOT try to wake them by shaking.

🛑 Call Emergency Services Immediately If

Call ambulance/doctor if ANY of these occur:

Seizure lasts > 5 minutes.

Breathing does not resume after the seizure.

Another seizure begins quickly (cluster).

Child is injured (bleeding, head trauma).

Child is diabetic, pregnant, or this is their first seizure.

You’re unsure or feel unsafe.

🧩 After the Jerking Stops (Post-ictal Phase)
4️⃣ Check Breathing

Most students will breathe normally after the jerking stops.

If breathing is normal → proceed to recovery position.

If NOT breathing → start CPR and call emergency help.

5️⃣ Place in Recovery Position

Turn child onto their side.

Keep head slightly tilted back.

This keeps the airway clear and prevents choking on saliva/vomit.

6️⃣ Stay With the Student

The student may feel:

tired or confused

headache

emotional, embarrassed

temporary weakness (Todd’s paralysis)

Speak softly and calmly:
“You’re safe. You had a seizure. Take your time.”

🧪 For Students With Known Epilepsy

Check their Seizure Action Plan (SAP) or medical file:

Some students have prescribed rescue medications (e.g., intranasal midazolam).

Only give rescue medicine if:

It is written in their medical plan

You are trained and authorized to give it

Timing criteria met (e.g., seizure > 3 minutes)

📘 Communicating With Parents

After the student recovers, inform parents with:

Duration of seizure

Triggers (stress, missed medication, fatigue, flashing lights, dehydration)

Any injuries

Whether rescue medication was used

Whether emergency services were called

🏫 School Prevention Strategies

Ensure known epileptic students have:

Individual Health Plan / Seizure Action Plan

Accessible rescue meds (if prescribed)

Teachers aware of triggers (stress, sleep deprivation, bright lights)

Avoid flashing light activities for photosensitive students.

Educate classmates to reduce fear and stigma.

Provide a quiet, supervised rest area after recovery.

✔ Quick Summary for Posters in School

When a tonic-clonic seizure happens:

DO:
✔ Protect from injury
✔ Cushion head
✔ Time the seizure
✔ After jerking stops → recovery position
✔ Stay with student

DON’T:
❌ Restrain
❌ Put anything in mouth
❌ Give food/drink
❌ Panic

Call Emergency Services if >5 minutes or injured.