Emergency treatment for seizures that last a long time

Most people have seizures that only last for a short time. These seizures usually stop by themselves, and don’t need emergency treatment.

Some people have seizures that last for longer than 30 minutes, or have one seizure that follows another without becoming conscious in between. This is called status epilepticus.

Research shows that using rescue medicine can stop the seizures at home or in the community.  Diazepam is given rectally (in the back passage).  Midazolam is given buccally (inside the cheek or nose.)

• More information about status epilepticus
  

Individual plans for emergency treatment

People with learning disabilities are often cared for by a wide range of service providers. It’s important that they all know what to do in case of an emergency.

If a person is likely to need rescue medicine (diazepam or midazolam), they should have an individual treatment plan. This should give essential information about when, and how, rescue medicine should be given. If the person doesn’t have a treatment plan, an epilepsy or learning disability nurse should be able to arrange one.

The person with epilepsy should be involved in the writing of the treatment plan, if they are able.

Consent

It’s important that the person who has a history of status epilepticus is involved as much as possible when a treatment plan is being written. This will give them the chance to give their informed consent.

Some people with epilepsy and learning disabilities are not able to make decisions about how they are treated. This means they can’t give informed consent. Each country in the UK has rules that say who should make important treatment and care decisions on behalf of people who can’t give consent. 

Mental Capacity Act 2005

The Mental Capacity Act 2005 is a law which covers people in England and Wales. It provides clear legal guidelines for making decisions for people over the age of 16 who can’t make decisions for themselves.

The Act says that people should be able to understand what the medical treatment is, what it will do, and why it is being proposed for them. They also need to be able to understand the benefits and risks of the treatment, and whether other treatments could be used instead.

The Act says that the person should understand what will happen to them if they don’t have the treatment. They should also be able to remember information long enough to make a decision. And, most importantly, they should have a choice of what happens to them, without being put under any pressure.

Adults with Incapacity (Scotland) Act 2000

In Scotland, the Adults with Incapacity (Scotland) Act 2000 allows doctors to authorise medical treatment, if the person doesn’t have the capacity to consent themselves.

People with learning disabilities who can’t consent to treatment may also have a Welfare Guardian appointed under this Act. This guardian is able to consent to medical treatment on behalf of the person with a learning disability.

Consent in Northern Ireland

There is no specific law to protect people who can’t give consent to their treatment. Therefore, the Mental Capacity Act, which covers England and Wales, is used as guidance.