Diastat

ruby_jane, BSN, RN · Aug 8, 2019

42 minutes ago, busybee22 said:
When is it appropriate to administer diastat? Am I right in saying that most students have some sort of parameter in the order, such as recurrent seizures in a certain amount of time or a seizure that lasts longer than x amount of minutes?
Whenever the orders say to....usually it's for a student with a known seizure disorder, seizures lasting longer than 5 minutes. In my experience it has been given to medically complex students (students with shunts where seizure is an absolute emergency). Last year I had diastat for a kid with absence seizures. I did call the prescribing neurologist's office. "Just in case."
Should you immediately call 911 if a student is having a seizure? I’m hoping this isn’t a stupid question. Obviously the safe answer is yes. But I know some people have seizures frequently and resolve quickly on their own so would it be safe to say that in a student with an ongoing history of frequent seizures, You may not necessarily have to call 911 if the seizure it resolves quickly and student returns to baseline (without diastat administration).
With a known seizure disorder....follow the treatment plan. General rule of thumb is no EMS in a known disorder with a seizure that lasts a minute or two BUT follow the IHP/Emergency Action plan. For a first time seizure with no known history, especially a tonic/clonic or full body seizure with LOC - always call EMS first, parent second.
I would love to hear any stories that y’all have on your experience with administering Diastat. I think that stories really help people to remember things and gives real life examples of Diastat administration (obviously not asking for HIPAA violations ?). Any other information about Diastat that you think would be helpful please let me know! Thanks so much!
In TX Diastat is considered a delegable medication whereas intranasal versed is not. I am forced by my district to train various and sundry people to administer Diastat. Because we don't have a way to practice this (like CPR on a dummy) I have negligible confidence that the staff will want to do this, and slightly more confidence in two people that they'd be able to do it. I would pause a moment to consult your BON to see if you can actually delegate Diastat administration. And when I check people off I always document "training via discussion and verbal teach-back, no manikin available to practice".
Good luck!!

BettyGirard, BSN · Aug 8, 2019

The only person I've delegated it to is the SPED teacher and she's pretty accustomed to things like that (she's Physically Disabled specialist). Response time is about 15 minutes to initial relief, it's way faster than the other option (oral, which might not be available at all, IV admin isn't available to us).

As pointed out, the patient should have orders as to when the diastat should be administered. It's always followed up with a EMS call.

Mango Juice · Aug 12, 2019

Visit the Wisconsin Department of Public Instruction website and do a search for the medication in question - this is a GREAT starting point.

Feral.Cat.Herder, RN · Aug 20, 2019

According to TN School Nurse and AHA recommendations - All volunteers trained to administer emergency anti-seizure medications shall also be trained in cardiopulmonary resuscitation (CPR) consistent with guidelines of the American Heart Association prior to anti-seizure medication training.

I am not sure of your school's policy or if CPR training may be something you want to ensure the volunteers have before Diastat training.

Best of Luck!!