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8. For Schools: Putting a Plan Into Practice

Having a seizure action plan on file is the start. This chapter covers the operational pieces that make it actually work on a normal school day, who to train, how to handle subs and field trips, medication, documentation, and privacy.

Who should be trained (and who should get the plan)

A seizure can happen anywhere in the building or on a trip, so training and plan-sharing reach well beyond the classroom teacher.

Train these roles (the Epilepsy Foundation's school-personnel course is built for all of them): classroom and special-education teachers, paraprofessionals/aides, substitute teachers, bus drivers, coaches and PE staff, cafeteria and front-office staff, librarians, administrators, and field-trip chaperones and volunteers.

Share the specific student's plan with every adult responsible for that student, the American Academy of Pediatrics lists teachers, recess and lunchroom supervisors, PE teachers, library staff, field-trip chaperones, and after-school staff.

Training should cover: recognizing common seizure types, the first-aid steps (Stay, Safe, Side), what makes a seizure a 911 emergency, rescue medications, and how to support the student.

Substitute teacher quick-reference

A substitute may be the only adult in the room when a seizure starts. Keep a short, current copy of the student's plan accessible to subs. A sub should be able to:

  1. Recognize a seizure (it may be staring or confusion, not just convulsions).
  2. Give basic first aid: Stay and time it, keep them Safe, turn them on their Side.
  3. Summon the trained staff member / nurse immediately (a sub usually does not give rescue medication).
  4. Call 911 if it lasts over 5 minutes, repeats, breathing is affected, there's injury, it happens in water, or it's a first-ever seizure.
  5. Have the parent and provider contacts from the plan on hand.

Field trips, off-site events, and transportation

The plan, and the ability to respond, must travel with the student.

  • Send the seizure action plan and the rescue medication with the student.
  • Ensure a trained staff member who can recognize a seizure, give first aid, and (where trained and delegated) administer rescue medication accompanies the student.
  • Notify the school nurse in advance so they can determine what's needed; whether a nurse must attend or care can be safely delegated to trained staff is a nursing judgment.
  • A student should not be excluded from a trip because of a seizure disorder.

Medication, administration, and delegation (Minnesota)

Minnesota's seizure law, Minn. Stat. 121A.24, requires each school to have a nurse or a trained designated person at every site who can administer or assist with seizure rescue medication, plus staff training and a copy of the plan for those responsible for the student.

Minnesota has no seizure-med 'self-carry' law

Minnesota's self-carry statutes cover asthma inhalers, epinephrine auto-injectors, certain pain relievers, and sunscreen, not seizure medication. So in Minnesota, seizure rescue medication is given by the nurse or a trained designated person under 121A.24, not carried and self-administered by the student like an inhaler.

Practical notes from the Epilepsy Foundation: common rescue medications include intranasal midazolam (Nayzilam), intranasal diazepam (Valtoco), and rectal diazepam (Diastat); nasal and rectal forms do not need refrigeration but must be stored safely and checked for expiration; only trained individuals should administer them. Nursing delegation (assigning a task to a trained unlicensed person) is made by the school nurse, not an administrator, and the nursing judgment itself is never delegated; it follows Minnesota's nurse practice act.

What to document after a seizure (observation log)

Good notes help the nurse, family, and doctor adjust care. Based on the Epilepsy Foundation's observation guidance, record:

  • Before: what the student was doing; any warning/aura; mood or behavior changes beforehand.
  • When: date and time.
  • Possible triggers: missed/late medication, sleep, illness, stress, lights, hunger, etc.
  • During: changes in awareness; movements (and where they started/which side); muscle tone; automatic movements (lip-smacking, picking); color/breathing changes; loss of bladder/bowel control.
  • Duration: length of aura, seizure, and recovery.
  • After (postictal): responsiveness, orientation, weakness, mood, need to sleep.
  • Response: rescue medication given (name, dose, time, by whom); any injury; who was notified (parent, nurse, 911).

A ready-to-use log is in EDAN's free packet. Download the free district packet (PDF)

Privacy: sharing the plan the right way (FERPA)

Sharing a student's seizure plan with staff is allowed and expected, you do not need fresh parental consent each time.

  • Under FERPA, a school may share information from education records with school officials who have a legitimate educational interest, the staff who need it to do their jobs (nurse, teachers, a trained bus driver, etc.).
  • FERPA also has a health-or-safety emergency exception: during an actual seizure emergency, the school may share necessary information (for example, with 911/EMS).
  • Most school health records are FERPA "education records," so HIPAA generally does not apply to them. Share on a need-to-know basis and keep the plan where responsible staff can reach it.

Sources: Epilepsy Foundation (school-personnel training, rescue-medication and observation guidance, model 504), CDC guidance for schools, American Academy of Pediatrics (Children with Epilepsy at School), NASN (delegation; school-sponsored trips), Minn. Stat. 121A.24 and 121A.22, U.S. Dept. of Education student-privacy guidance (FERPA; FERPA/HIPAA joint guidance).