New seizure response protocol

As you are probably aware, Maureen experienced a minimum of four seizure events during the week of August 21.

From the beginning, we have established two overall goals to guide our collective efforts:

• Provide quality, consistent and compassionate care

• Maximize Maureen’s quality of life

Tom, Carolyn and I had discussions about how to best handle future seizure events with the medical professionals at JourneyCare and with an eminently qualified pharmacist who is a close family friend. The end result of these discussions is the following protocol: Seizure symptoms/signs

• Eyes wide open with little or no blinking

• Rapid eye movement from side to side

• Little or no responsiveness to verbal cues

• Tightly clenched fists

• Clenched jaw

• Foaming from the mouth

• Convulsions/spasms in arms and/or legs

Response protocol

If you observe any one or a combination of these symptoms, take the following steps:

1. Position Maureen on her side. Ensure that her airway/mouth is completely clear.

2. Immediately administer an initial dose of 0.5ml of Lorazepam under Maureen’s tongue or between her cheek and gum. The Lorazepam is stored in the refrigerator on the second shelf in a white One Point Pharmacy bag. Use the syringe in the box to administer the Lorazepam.

3. If Tom is out of the house, call his mobile phone to inform him that a seizure event is underway.

4. If after three minutes any one or a combination of the above referenced symptoms/signs persist, administer a second 0.5ml dose of Lorazepam

5. Should the seizure continue, administer additional 0.5ml doses every 3 minutes until you have given Maureen a total of six doses over an 18-minute period.

Potential additional anti-seizure medication: Keppra If Maureen should experience another seizure, we will add a second anti-seizure medication, Keppra, to her daily regimen. This may or may not be a permanent addition. We will make an initial assessment of the drug’s efficacy and any adverse side effects after several days. Please contact Tom, Carolyn or me with any questions you may have.