Downloadable Seizure Forms - Epilepsy Foundation
Seizure Action (or Response) Plans are available in English and other languages for all ages and any setting. The seizure action plan and additional forms help you create a plan to manage and respond to seizures.
SEIZURE ACTION PLAN (SAP) How to respond to a seizure (check all that apply) F. First aid – Stay. Safe. Side. F. Notify emergency contact at _____ F Give rescue therapy according to SAP . F. Call 911 for transport to _____ F Notify emergency contact . F. Other _____ Seizure Type
Seizure Action Plans - Epilepsy Foundation
Find steps and forms for building your individualized plan for managing your epilepsy and responding to seizure emergencies. Why is it important to have a Seizure Action (or Response) Plan? You and your family play in central role in your seizure management.
ADULT Seizure Action Plan & Patient Questionnaire SEIZURE INFORMATION: 1. When was your epilepsy diagnosed? 2. Will you need to leave the area after a seizure? YES NO If YES, describe best process for returning: 3. How often do you have seizures? 4. When was the last seizure? 5. Has there been any recent change in your seizure patterns?
Record Duration and time of each seizure(s) Call 911 if: When EMS arrives, a medical provider will perform an individual assessment to determine appropriate next steps.
☐ Seizure with loss of consciousness longer than 5 minutes, not responding to rescue medication (if applicable for student) ☐ Repeated seizures longer than 10 minutes, no recovery in between seizures, not responding to rescue medication (if applicable for student) ☐ Difficulty breathing after seizure ☐ Seizure injury occurs or is ...
A seizure action plan can provide clarification on patient and caregiver concerns, such as understanding what to do during a seizure, when watchful waiting is appropriate, when to intervene with at-home rescue medications,
SEIZURE FIRST AID LEARN MORE AND GET A DOWNLOADABLE VERSION OF THIS ACTION PLAN AT: SCHOOL SEIZURE ACTION PLAN ¥ Student has a convulsive seizures lasting more than minutes ¥ Student has repeated seizures without regaining consciousness ¥ Student is injured or has diabetes ¥ Student is having breathing difÞculty
SAP Examples - Seizure Action Plans
Create your own Seizure Action Plan today using one of these tools. Epilepsy Alliance America SAP (fillable) – With helpful pictures. Individualized SAP (fillable) – Good for those with severe epilepsy who need space to write out their custom plan.
Record Duration and time of each seizure(s) • Child has a convulsive seizures lasting more than minuest • Child has repeated seizures without regaining consciousness