INTRODUCTION TRAINING PROGRAMME Berkshire West Primary Care Trusts EPILEPSY AND THE ADMINISTRATION OF RECTAL DIAZEPAM INTRODUCTION TRAINING PROGRAMME Berkshire West Primary Care Trusts is a collaboration between Newbury and Community, Reading and Wokingham PCTs

EPILEPSY AND THE ADMINISTRATION OF RECTAL DIAZEPAM AIMS OF THE SESSION: to demonstrate how and when to give Rectal Diazepam to offer advice to help staff to cope with an emergency situation with a client who has epilepsy

LEARNING OUTCOMES RECTAL DIAZEPAM have received instruction in the administration of Rectal Diazepam have received instruction in the appropriate use of the documentation required be informed of the emergency procedures if Rectal Diazepam fails to control a seizure or cannot be given

WHAT IS RECTAL DIAZEPAM? Diazepam has anticonvulsant, anxiety reduction, sedative and muscle relaxant effects It is given rectally as the medication is readily absorbed via this route

Respiratory depression SIDE EFFECTS Drowsiness Respiratory depression Muscle weakness Slurred speech Confusion Fatigue Depression

WHY GIVE RECTAL DIAZEPAM? To Stop Prolonged Seizures To Prevent Status Epilepticus To Prevent Seizure Clusters

WHEN TO GIVE RECTAL DIAZEPAM AS AN EMERGENCY PROCEDURE When seizure fails to stop within time indicated on care-plan or When the person has had a number of seizures within a prescribed time as indicated on the care-plan

POSSIBLE PROBLEMS IN ADMINISTERING RECTAL DIAZEPAM Tension/spasm of the rectum (inserting the rectal tube too quickly The seizure may begin again Prolapse of the rectum/piles Constipation Incontinence of faeces

O/H Care Plan Policy/Procedure

PRIOR TO THE ADMINISTRATION OF RECTAL DIAZEPAM Before you start note time of onset of seizure alert second member of staff collect medication pack Always check with another person consent name dose expiry date

PROCEDURES FOR ADMINISTRATION OF RECTAL DIAZEPAM If no improvement after 5 mins or as stated on the careplan administer Rectal Diazepam and note time lay person on left side or on back (with a cushion under buttocks, if possible) 2. put on protective gloves 3. remove cap from end of tube carefully insert nozzle into the rectum (1/2 length of nozzle in children under two) and squeeze pack empty slowly remove nozzle continuing to squeeze Sachet. Hold person’s buttocks together for a few minutes, if possible, to prevent leakage 6. lie person in recovery position to sleep, keep person under close observation If seizure has not stopped after 10 mins or as stated in the careplan DIAL 999 for an ambulance The person should be escorted to hospital if at all possible

ADMINISTRATION OF RECTAL DIAZEPAM inform all carers involved, e.g. residential, home, day centre staff, parents complete Record of Use of Diazepam complete and send notification form to home/parent/carer

EMERGENCY PROCEDURES 999 CPR

IN THE EVENT OF ADMISSION TO HOSPITAL It is important that the following details accompany the person: time of onset of seizure, trigger, length of seizure and length of recovery time and dose of rectal diazepam given continence personal details

SUMMARY know your client follow agreed procedure keep accurate records maintain good communication between all concerned review epilepsy medication regularly with GP or Consultant

CONTACT DETAILS READING LOCALITY Fiona Simpson/Barbara Chandler, Reading Community Team for People with Learning Disability, PO Box 2624, Reading, RG1 7WB  0118 955 3742 NEWBURY LOCALITY Nicky Macdonald, Newbury Community Team for People with Learning Disability, Northcroft Wing, Avonbank House, West Street,Newbury, RG14 1BZ  01635 503120 WOKINGHAM LOCALITY Mary Codling, Wokingham Team for People with Learning Disability, 2nd Floor, Wellington House, Wellington Rd, Wokingham, RG40 2AG  0118 974 6832/0118 949 5000