Quality statement 6: Prolonged or repeated seizures

Quality statement

Children and young people with a history of prolonged or repeated seizures have an agreed written emergency care plan.

Rationale

An emergency care plan is an important tool in improving the quality of emergency care in the community. It ensures that previous incidents and the agreed treatment strategies are taken into account by healthcare professionals. It also provides guidance for family members or carers who may need to administer emergency treatment. The timely and appropriate management of a prolonged or repeated seizure may significantly reduce the risk of mortality and morbidity (long-term complications) known to be associated with prolonged or repeated seizures.

Quality measure

Structure: Evidence of local arrangements for children and young people with a history of prolonged or repeated seizures to have an agreed written emergency care plan.

Process: Proportion of children and young people with a history of prolonged or repeated seizures who have an agreed written emergency care plan.

Numerator – the number of people in the denominator who have an agreed written emergency care plan.

Denominator – the number of children and young people with a history of prolonged or repeated seizures.

Outcome:

a) Accident and emergency attendances for prolonged or repeated seizures.

b) Hospital admissions for prolonged or repeated seizures.

c) Patient or parent/carer satisfaction with emergency care for prolonged or repeated seizures.

What the quality statement means for each audience

Service providers ensure systems are in place for children and young people with a history of prolonged or repeated seizures to have an agreed written emergency care plan.

Healthcare professionals ensure that children and young people with a history of prolonged or repeated seizures have an agreed written emergency care plan.

Commissioners ensure they commission services for children and young people with a history of prolonged or repeated seizures to have an agreed written emergency care plan.

Children and young people who have had a prolonged seizure (a seizure that lasted 5 minutes or longer) or repeated seizures (3 or more seizures within 1 hour) have a written emergency care plan agreed between them, their parents or carers and their healthcare team that sets out how they should be cared for if they have prolonged or repeated seizures again.

Source guidance

NICE clinical guideline 137 recommendation 1.14.1.4.

Data source

Structure: Local data collection.

Process: Local data collection.

Outcome:

a) Hospital episode statistics contain the data necessary for the monitoring of accident and emergency attendances.

b) and c) Local data collection.

Definitions

An agreed written emergency care plan should describe what happens in the event of a prolonged or repeated seizure, including pharmacological treatment that should be given and actions to take, who to contact and when. It should be agreed between the child or young person with epilepsy, their family and/or carers if appropriate and their primary and secondary healthcare professionals. Family members and/or carers of children and young people with epilepsy will need training to initiate treatment at home or in the community when necessary. The plan should be reviewed at least annually.

Prolonged seizures are seizures that last 5 minutes or more.

Repeated seizures are seizures that occur 3 times or more within 1 hour.

Any child or young person with epilepsy who has experienced a prolonged or repeated seizure is considered to have a history of prolonged or repeated seizures.