Emergencies and Status Epilepticus

This chapter may be one of the most vital in the whole book. Knowing when a long seizure becomes an emergency, and what to do in that moment, is critically important for your child's safety. Please read this chapter carefully and, if needed, review it together with your doctor.

What Is Status Epilepticus?

Most seizures stop on their own within a few minutes. But if a seizure lasts a very long time, or if seizures happen one after another without the child coming round in between, this is called status epilepticus, and it is a medical emergency. As a general rule, a seizure lasting longer than 5 minutes is treated as a situation requiring urgent action, because it's less likely to stop on its own. The longer it lasts, the harder it becomes to stop; that's why time is very precious.

The 5-minute rule

When a seizure starts, look at the clock. In a moment of panic, it's impossible to judge time accurately.

If the seizure goes past 5 minutes, or reaches the time your doctor told you, put your emergency action plan into effect.

Rescue (Emergency) Medicines

For children at risk of long seizures, your doctor may prescribe a rescue medicine to stop a seizure at home or at school. These medicines usually come in forms given rectally (through the bottom) or into the cheek/nose; they don't require a vein, so you can give them yourself at home. They work quickly, aiming to bring the seizure to an end.

Be prepared in advance for the rescue medicine

If your child has been prescribed a rescue medicine, learn directly from your doctor or nurse how, when, and how much to give, and if needed, practice giving it together.

Check the medicine's expiry date regularly and always keep it somewhere you can reach (at home, in a bag, at school).

Prepare a written emergency action plan (there's a template in the Appendices section): when the medicine will be given, what to do next, who to call. Give a copy of this plan to the school as well.

When Should You Call 112?

You don't need to call for emergency help with every seizure; but in the situations below, call the 112 Emergency Line without losing any time:

• If the seizure lasts longer than 5 minutes (or goes beyond the time your doctor specified).
• If a new seizure starts as soon as one ends, before the child has come round.
• If, after the seizure, the child isn't breathing normally, turns blue, or their consciousness doesn't return for a long time.
• If the seizure happened in water (in the bath, in a pool), or a serious injury occurred during the seizure.
• If the child is having their first seizure and the cause is unknown.
• If you gave the rescue medicine but the seizure doesn't stop.
• If you instinctively feel the situation is different from usual and more serious — trust your intuition.

We recommend reading the information in this chapter together with the detailed first aid guide in the next part (Chapter 29). Together, the two give you complete preparation that will make you feel confident in an emergency.