POLICY CONTENT

Epilepsy refers to recurring seizures where there is a disruption of normal electrical activity in the brain that can cause momentary lapses of consciousness, or sudden loss of body control (Epilepsy Australia, 2019). The effects of epilepsy can vary, some children will suffer no adverse effects while epilepsy may impact others greatly. Some children with epilepsy may have absence seizures where they are briefly unconscious. Our School will implement inclusive practices to cater for the additional requirements of children with epilepsy in a respectful and confidential manner. 
 

NATIONAL QUALITY STANDARD (NQS)

QUALITY AREA 2: Children's Health and Safety

 

2.1.1	Wellbeing and comfort	Each child’s wellbeing and comfort is provided for, including appropriate opportunities to meet each child’s needs for sleep, rest and relaxation.
2.1.2	Health practices and procedures	Effective illness and injury management and hygiene practices are promoted and implemented.
2.2	Safety	Each child is protected.
2.2.1	Supervision	At all times, reasonable precautions and adequate supervision ensure children are protected from harm and hazard.
2.2.2	Incident and emergency management	Plans to effectively manage incidents and emergencies are developed in consultation with relevant authorities, practiced and implemented.

PURPOSE

The Education and Care Services National Regulations requires approved providers to ensure their services have policies and procedures in place for medical conditions. Our School is committed to providing a safe and healthy environment that is inclusive for all children, staff, visitors, and family members who have been diagnosed with epilepsy. The aim of this policy is to ensure that educators and staff are aware of their obligations in supporting children with epilepsy and work in partnership with families and health professionals to manage seizures by following the child’s medical management plan. 
 

SCOPE

This policy applies to children, families, staff, management, and visitors of the School. 
 

DUTY OF CARE 

Our School has a legal responsibility to take reasonable steps to ensure that the health needs of all children enrolled in the school are met. This includes our responsibility to provide: 

1. a safe environment free from foreseeable harm and  
2. adequate supervision for all children at all times.

 
Staff members including relief staff must have adequate knowledge about epilepsy and the management of seizures to ensure the safety and wellbeing of the children.  
 

BACKGROUND AND LEGISLATION

Epilepsy is a common, serious neurological condition characterised by recurrent seizures due to abnormal electrical activity in the brain. While about 1 in 200 children live with epilepsy, the impact is variable – some children are greatly affected while others are not. Epilepsy is unique. There are virtually no generalisations that can be made about how epilepsy may affect a child. There is often no way to accurately predict how a child’s abilities, learning, and skills will be affected by seizures. Because the child’s brain is still developing, the child, their family and doctor will be discovering more about the condition as they develop.  
 
The most important thing to do when working with a child with epilepsy is to get to know the individual child and their condition. All children with epilepsy should have a medical management plan. It is important that all those working with children living with epilepsy have a thorough understanding of the effects of seizures, required medication and appropriate first aid.  
 
Legislation that governs the operation of approved children’s services is based on the health, safety and welfare of children, and requires that children be protected from hazards and harm. National Regulations of the Education and Care Services requires the Approved Provider to ensure that there is at least one educator on duty at all times who has a current approved first aid qualification. As a demonstration of duty of care and best practice, it is recommended that all educators have current approved first aid qualifications. 
 

IMPLEMENTATION

We will involve all educators, families and children in regular discussions about medical conditions and general health and wellbeing throughout our curriculum. The School will adhere to privacy and confidentiality procedures when dealing with individual health needs including having families provide written permission to display the child’s Medical Management Plan in prominent positions within the School.  
 
 
Children diagnosed with epilepsy will not be enrolled into the School until the child’s medical management plan is completed and signed by their medical practitioner. A risk minimisation and communication plan must be developed with parents/guardians to ensure risks are minimised and strategies developed for minimising any risk to the child.  
 
It is imperative that all educators and volunteers at the School follow a child’s Medical Management Plan in the event of an incident related to a child’s specific health care need, allergy or medical condition. 
 
Management, Nominated Supervisor/ Responsible Person will ensure:

• before the child’s enrolment commences, the family will meet with the School and its educators to begin the communication process for managing the child’s medical condition in adherence with the registered medical practitioner or health professional’s instructions 
• parents/guardians of an enrolled child who is diagnosed with epilepsy are provided with a copy of the Epilepsy Management Policy, Medical Conditions Policy and Administration of Medication Policy 
• all children enrolled at the School with epilepsy must have an epilepsy medical management plan, seizure record and, where relevant, an emergency action plan, signed by a registered medical practitioner and a copy filed with their enrolment record. Records must be no more than 12 months old and updated regularly by the child’s registered medical practitioner and/or neurologist.  
• the medical management plan will describe the prescribed medication for that child and the circumstances in which the medication should be administered 
• individual epilepsy medical management will be displayed in key locations throughout the School 
• a risk minimisation plan is developed in consultation with the parents of a child diagnosed with epilepsy outlining procedures to minimise the incidence and effect of a child’s epilepsy. The plan will cover the child’s known triggers and where relevant other common triggers which may cause an epileptic seizure. 
• that no child who has been prescribed epilepsy medication attends the School without the medication  
• they collaborate with parents/guardians to create and implement a communication plan and encourage ongoing communication between parents/guardians and staff regarding the current status of the child’s medical condition, this policy, and its implementation 
• a copy of this policy is provided and reviewed during each new staff member’s induction process 
• all staff members have completed first aid training approved by ACECQA at least every 3 years and that this is recorded, with a copy of each staff members’ certificate held on the School’s premises 
• all staff attend regular training on the management of epilepsy and, where appropriate, emergency management of seizures using emergency epileptic medication, when a child with epilepsy is enrolled at the School 
• all staff members are trained to identify children displaying the symptoms of a seizure and are aware of the child’s epilepsy medical management plan and required medication (if applicable) 
• updated information, resources and support is regularly given to families for managing epilepsy 
• that a staff member accompanying children on excursions or to events outside the School carries the prescribed medication and a copy of the epilepsy medical management/action plan and for children diagnosed with epilepsy 
• that they notify the Regulatory Authority of any serious incident of a child while being educated and cared for at the school within 24 hours.

 
Educators will:

• read and comply with the Epilepsy Management Policy, Medical Conditions Policy and Administration of Medication Policy 
• ensure a copy of the child’s epilepsy medical management plan is visible and known to staff and volunteers in a School 
• recognise the symptoms of a seizure and treat appropriately and in accordance with the child’s epilepsy medical management plan in the event of a seizure 
• record all epileptic seizures according to the epilepsy medical management plan 
• take all personal epilepsy medical management plans, seizure records, medication records, emergency action plans and any prescribed medication on excursions and other events 
• administer prescribed medication when needed according to the medical management plan in accordance with the School’s Administration of Medication Policy 
• identify and where possible, minimise possible seizure triggers as outlined in the child’s epilepsy medical management plan and risk minimisation plan 
• communicate with the parents/guardians of children with epilepsy in relation to the health and safety of their child, and the supervised management of the child’s epilepsy 
• ensure that children with epilepsy can participate in all activities safely and to their full potential 
• increase supervision of a child diagnosed with epilepsy on special occasions such as excursions, incursions, parties and family days 
• maintain a record of the expiry date of the prescribed epilepsy management medication so as to ensure it is replaced prior to expiry

 
Families will: 

• provide information upon enrolment or on diagnosis, of their child’s medical condition-epilepsy 
• provide staff with an epilepsy medical management plan developed and signed by a registered medical practitioner  
• develop a risk minimisation plan in collaboration with the Nominated Supervisor/Responsible Person  and lead educators 
• develop a communication plan in collaboration with the Nominated Supervisor/Responsible Person and lead educators 
• provide staff with prescribed medications each day their child attends care 
• maintain a record of the expiry date of medication and ensure it is replaced prior to expiry 
• notify staff of any changes to their child’s medical condition including the provision of a new epilepsy medical management plan to reflect these changes as needed 
• communicate all relevant information and concerns to staff, for example, any matter relating to the health of the child.

 
If a child is known to have an epileptic condition and has a seizure, School and staff will: 

• Follow the child’s medical management /action plan  
• Protect the child from injury- remove any hazards that the child could come into contact with 
• Not restrain the child or put anything in their mouth 
• Gently roll them on to the side in the recovery position as soon as possible (not required if, for example, child is safe in a wheelchair safe and airway is clear) 
• Monitor the airway 
• Call an ambulance immediately by dialling 000 if:  
  • a seizure continues for more than three minutes 
  • another seizure quickly follows the first 
  • it is the child’s first seizure 
  • the child is having more seizures than is usual for them 
  • certain medication has been administered 
  • they suspect breathing difficulty or injury
• Continue first aid measures 
• Contact the parent/guardian when practicable 
• Contact the emergency contact if the parents or guardian can’t be contacted when practicable 
• If the incident presented imminent or severe risk to the health, safety and wellbeing of the child or if an ambulance was called in response to the emergency (not as a precaution) the regulatory authority will be notified within 24 hours of the incident through the NQA IT System (as per regulations)

 
The above procedure should be followed if a child who is not diagnosed as epileptic experiences a seizure whilst attending the School. 
 
 

DEFINITIONS

FOCAL SEIZURES

GENERALISED SEIZURES

 

Tonic-clonic Seizures	Tonic-clonic seizures produce sudden loss of consciousness, with the person commonly falling to the ground, followed by stiffening (tonic) and then rhythmic jerking (clonic) of the muscles. Shallow or 'jerky' breathing, bluish tinge of the skin and lips, drooling of saliva and often loss of bladder or bowel control generally occur.   The seizures usually last one to three minutes and normal breathing and consciousness then returns. The person is tired following the seizure and may be confused. If the seizures last more than five minutes an ambulance should immediately be called.
Absence Seizures	Absence seizures (previously called petit mal seizures) produce a brief cessation of activity and loss of consciousness, usually lasting less than 10 seconds. Often the momentary blank stare is accompanied by subtle eye blinking and mouthing or chewing movements. Awareness returns quickly and the person continues with the previous activity. Falling and jerking do not occur in typical absences.
Myoclonic Seizures	Myoclonic seizures are sudden and brief muscle contractions usually only lasting a second or two, that may occur singly, repeatedly or continuously. They may involve the whole body in a massive jerk or spasm or may only involve individual limbs or muscle groups. If they involve the arms, they may cause the person to spill what they were holding. If they involve the legs or body the person may fall.
Tonic Seizures	Tonic seizures are characterised by generalised muscle stiffening, lasting 1-10 seconds. Associated features include brief cessation of breathing, colour change and drooling.   Tonic seizures often occur during sleep. When tonic seizures occur suddenly with the child awake, they may fall violently to the ground and injure themselves. Fortunately, tonic seizures are rare and usually only occur in severe forms of epilepsy.
Atonic Seizures	Atonic seizures produce a sudden loss of muscle tone that, if brief, may only involve the head dropping forward ('head nods'), but may cause sudden collapse and falling ('drop attacks').

Source: Epilepsy Australia (2019). 
 
 

RESOURCES/POSTERS

Animated Seizure Firs-Aid video for children 
Seizure first aid posters 
  

SOURCE

Australian Children’s Education & Care Quality Authority. (2014).  
Early Childhood Australia Code of Ethics. (2016). 
Education and Care Services National Law Act 2010. (Amended 2018). 
Education and Care Services National Regulations. (2011).      
Epilepsy Australia. (2021). epilepsyaustralia.net/ 
Epilepsy Action Australia. (2020). epilepsy.org.au/ 
Guide to the Education and Care Services National Law and the Education and Care Services National Regulations. (2017).  
Guide to the National Quality Standard. (2020). 
National Health and Medical Research Council. (2012) (updated June 2013). Staying healthy: Preventing infectious diseases in early childhood education and care services. 
Revised National Quality Standard. (2018). 
The Royal Children’s Hospital Melbourne: rch.org.au/neurology/patient_information...