OBJECTIVE:This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK. SITUATION ANALYSIS:Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. RECOMMENDATIONS:A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. IMPLICATIONS:Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall.

译文

目的:本文探讨了在英国主流学校向长期发作性惊厥发作的儿童服用急救药物的讨论中出现的问题。
情况分析:目前的指南建议对患有此类癫痫发作(定义为持续发作超过5分钟)的儿童立即进行治疗,以防止其发展为癫痫持续状态和神经系统疾病。由于儿童在长时间的抽搐发作中会失去知觉,因此他们是否及时接受治疗取决于是否有受过训练并能够施行急救药物的老师或其他工作人员在场。但是,人们认为学校之间的情况各不相同,并且主要取决于当地的商誉和可用资源。
建议:需要更系统的响应,以确保无论癫痫发作在哪里发生,儿童都可以接受急救药物。可能的前进方式包括:进一步利用癫痫志愿部门组织提供的学校培训资源;向学校提供一致的实用信息;透明的指南,概述了从医院到学校的清晰护理路径;实施和遵守每个孩子的个人保健计划。
含义:需要在学校上班时间长时间进行惊厥性癫痫发作的儿童,需要测试以人为本的综合护理以及国家卫生局(NHS)向往的联合工作的目标。随着NHS的变化开始发挥作用,并且当地服务进行了重新配置,应在最大范围内提高整体儿科癫痫服务质量的范围内,尽一切努力考虑到这一弱势儿童群体的特殊需求。

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