Medical conditions: Epilepsy and seizures policy and procedure

Early Learning Victoria is committed to the safety, health and wellbeing of children in its care, including children with epilepsy and seizures. We are committed to providing Early Learning Victoria centre staff with the information, training and skills they need to support children with epilepsy and seizures and respond effectively in an emergency.

1. Scope

This policy applies to children, families, staff, management and visitors of Early Learning Victoria centres. This includes volunteers, students on placement and contractors or labour hire employees of Early Learning Victoria.

2. Policy statement

This policy describes procedures to be implemented at Early Learning Victoria centres to:

ensure that staff support children diagnosed with epilepsy and children having a non-epileptic seizure event appropriately
raise awareness of epilepsy and appropriate management among all staff through education and policy implementation
work with parents or guardians of children diagnosed with epilepsy in understanding risks and developing and implementing risk minimisation strategies and communication plans to support the child and help keep them safe.

This policy should be read in conjunction with:

Administering medication policy and procedure
Administration of first aid policy and procedure
Management of medical conditions policy and procedure
Incident, injury, trauma and illness policy.

2.1 Requirements

Under the Education and Care Services National Law Act 2010 and Education and Care Services National Regulations 2011 (the Regulations), Early Learning Victoria must ensure:

that this policy is displayed at the service, its procedures are adhered to and it is reviewed annually
that all staff, families, contractors, volunteers and students are provided with a copy of this policy and have read and understood it
families are aware of expectations for their role in developing a Risk Minimisation Plan and communication plan with their centre.

2.2 Background and information

Epilepsy is a common, serious neurological condition characterised by recurrent seizures due to abnormal electrical activity in the brain. While about 1 in 200 children live with epilepsy, the impact is variable – some children are greatly affected while others are not.

Approximately 70% of people living with epilepsy have good control of their seizures through medication. However, it is important that all those working with children living with epilepsy have a sound understanding of the effects of seizures, required medication and appropriate first aid for seizures.

The Epilepsy Foundation has a range of resources and can assist with the development of an Epilepsy Management Plan. The Epilepsy Foundation also provides training and support to families and educators in understanding and managing epilepsy and, when indicated, the administration of emergency medication.

The Regulations require approved providers to ensure that there is at least one educator on duty at all times who has a current approved first aid qualification. As a demonstration of duty of care and best practice, all Early Learning Victoria educators hold current and approved first aid qualifications and receive regular training in managing specific health care needs.

3. Actions and procedures

3.1 Responsibilities of families

Families are responsible for:

reading this policy and procedure
informing staff (either on enrolment or on initial diagnosis) that their child has epilepsy
providing a copy of their child’s Epilepsy Management Plan (including an Emergency Medication Management Plan if relevant) to the centre (and updating this annually or sooner if there are any changes to the information)
ensuring the medication record is completed in accordance with the Administering medication policy and procedure
working with staff to develop a risk minimisation plan for their child
providing emergency medication for their child, if prescribed, and ensuring centres always have an adequate supply
communicating regularly with staff in relation to the ongoing health and wellbeing of their child, and the management of their child’s epilepsy
encouraging their child to learn about their epilepsy, and to communicate with staff if they are unwell or experiencing symptoms of a potential seizure.

3.2 Responsibilities of staff

Individualised Epilepsy Management Plan

For children diagnosed with epilepsy, an individualised Epilepsy Management Plan (see Links) must be completed by a medical practitioner and provided to the nominated supervisor to document a child’s seizures and the strategies that will be used. This must be done before the child’s orientation, or when the centre is informed about the child’s diagnosis.

The plan must include appropriate risk minimisation strategies that will be implemented to manage the child’s epilepsy and seizures, both onsite and offsite during excursions. The plan must be agreed to and signed by the child’s parent or guardian, and must be reviewed annually or sooner, if the child’s diagnosis or management change.

Risk minimisation plan

It is important to consult with families to determine which strategies are appropriate for reducing the risks related to the child’s epilepsy and seizures. This should be done as part of developing the child’s Epilepsy Management Plan.

The risk minimisation plan must be developed in partnership with the parent or guardian and in consultation with the child’s medical practitioner, or with the Epilepsy Foundation. The risk minimisation plans should be developed for day-to-day seizure management at the centre and for excursions, as the risks are different (see Epilepsy Foundation: Epilepsy and Seizure Management Plan).

Communication plan

The nominated supervisor is responsible for ensuring that a communication plan is developed to provide information to all centre staff, volunteers, students and families about epilepsy and seizures and this policy. The communication plan must include strategies for advising staff, volunteers, students and families about how to respond to a child experiencing seizure in various environments, including during excursions.

Emergency response

In the instance of any seizure, Early Learning Victoria must follow the seizure first aid and emergency response instructions in the child’s Epilepsy Management Plan.

If the child has an Emergency Medication Management Plan, only staff trained to do so should follow the instructions in the plan. If no staff present are trained to administer emergency medication, an ambulance should be called immediately.

In the instance of no Epilepsy Management Plan, an ambulance should be called immediately and standard seizure first aid principles followed. This includes timing the seizure, protecting the person from injury, rolling them onto their side if they are not alert and staying with them until the seizure has resolved.

ELV should call an ambulance immediately if:

there is no Epilepsy Management Plan
a serious injury has occurred
the child’s airway or breathing is compromised
other factors outlined in the Epilepsy Management Plan are occurring.

Incident reporting

If a child experiences a seizure, Early Learning Victoria centre staff will complete an incident report (see the Incident, injury, trauma and illness policy). The nominated supervisor will work with Early Learning Victoria central office to:

notify the Regulatory Authority of serious incidents online through the NQA IT System, if required
record the incident appropriately (using, for example, the Incident, injury, trauma and illness record or EduSafe Plus for staff-related incidents).

Staff will be offered a debrief after each incident. An emergency can cause distress not only for the child, but for staff and other children, especially if the event was life-threatening.

Educators are responsible for:
- ensuring they are aware of the epilepsy and seizure first aid procedures
- ensuring they can identify children displaying the symptoms of a seizure, and locate their personal medication and Emergency Management Plan
- maintaining current approved first aid qualifications
- identifying and if possible minimising possible seizure triggers, as outlined in the child’s Epilepsy Management Plan
- being aware of and sensitive to possible side effects and behavioural changes following a seizure, or following changes to the child’s medication regime
- consulting with the parents or guardians of children with epilepsy in relation to the health and safety of their child, and the supervised management of the child’s epilepsy
- communicating any concerns to parents or guardians if a child’s epilepsy is limiting their ability to participate fully in all activities
- ensuring children with epilepsy are not discriminated against in any way and that they can participate in all activities safely and to their full potential
- ensuring emergency medication is stored correctly and is in-date
- administering prescribed medication in accordance with the Administering medication policy and procedure
- ensuring that families have provided written authorisation before their child attends excursions (see the Excursions, incursions and regular outings policy and procedure)
- following appropriate procedures set out in the Incident, injury, trauma and illness policy if a child is ill or involved in a medical emergency or an incident at the centre
- ensuring the medication and the individualised Epilepsy Management Plan, Seizure Management Plan and Emergency Medication Plan are kept together in a kit and are accessible to staff when children are inside, outside or on excursions.
The nominated supervisor is responsible for:
- ensuring medication is administered and stored in accordance with the Administering medication policy and procedure and information provided in the child’s Emergency Management Plan
- compiling a list of children with epilepsy and placing this and the Epilepsy Management Plan, seizure record and Emergency Medical Management Plan for each child with epilepsy in a secure, yet readily accessible location for all staff
- ensuring induction procedures for casual and relief staff include information about children attending the service who have been diagnosed with epilepsy, and the location of their medication and management plans
- ensuring programmed activities and experiences consider the individual needs of all children, including any children with epilepsy
- ensuring a current Epilepsy Management Plan, Seizure Management Plan and Emergency Medication Management Plan, if required, are prepared and signed by the child’s medical practitioner. These should be provided as part of the child’s health information during enrolment or on diagnosis and recorded in the enrolment record for that child
- ensuring that an individualised care plan is developed in consultation with the child’s parents or guardians and is co-signed. The plan will include written permission to display the child’s Epilepsy Management Plan on the wall in appropriate places and to share the information in the plan with Early Learning Victoria staff
- ensuring the individualised epilepsy care plan is reviewed at the start of each year, in consultation with the child’s parents or guardians, so that information is up to date and strategies to reduce risk remain age-appropriate
- ensuring they can identify children displaying the symptoms of a seizure, and locate their personal medication and Epilepsy Management Plan, and Emergency Medication Management Plan, if provided
- ensuring medication and Epilepsy Management Plans are taken whenever the child goes to offsite activities, in accordance with the excursion or regular outings plan, and that a risk management plan is completed (see the Excursions, incursions and regular outings policy and procedure)
- following appropriate procedures set out in the Incident, injury, trauma and illness policy if a child is ill, or is involved in a medical emergency or an incident at the centre
- ensuring a poster displaying details of children diagnosed medical conditions (alongside a photo of each child) is displayed in the staff room or a suitably private location.
The approved provider is responsible for:
- establishing robust induction procedures that include the provision of information for implementing practices outlined in this policy
- ensuring all staff have current CPR training and are aware of seizure first aid procedures when a child with epilepsy is enrolled at an Early Learning Victoria centre
- ensuring staff attend relevant training, including training that may be conducted by the Epilepsy Foundation, on the management of epilepsy and where appropriate, the administration of emergency medication for the management of seizures, when a child with epilepsy is enrolled in their group
- ensuring children with epilepsy are not discriminated against in any way and can participate in all activities safely and to their full potential
- immediately communicating any concerns with parents or guardians about the management of children with epilepsy
- working with the nominated supervisor to notify the Regulatory Authority of a serious incident using the NQA IT System (see the Incident, injury, trauma and illness policy).

4. Resources

Legislation and standards

Education and Care Services National Law 2010
Education and Care Services National Regulations 2011
Disability Discrimination Act 1992
National Quality Standard, Quality area 2: Children’s health and safety
Occupational Health and Safety Act 2004
Occupational Health and Safety Regulations 2017
Privacy and Data Protection Act 2014
Privacy Act 1988
Public Health and Wellbeing Act 2008
Public Health and Wellbeing Regulations 20019

Administering medication policy and procedure
Administration of first aid policy and procedure
Anti-bias approach policy
Duty of care policy
Incident, injury, trauma and illness policy
Management of medical conditions policy and procedure
Staffing overview policy

Definitions

Absence seizure: Occurring mostly in children, this consists of brief periods of loss of awareness, most often for less than 10 seconds. Some children can experience these types of seizures multiple times during the day, which may compromise learning. Absence seizures can be mistaken for daydreaming.

ASMs: Anti-seizure medications used for the treatment of many epilepsy syndromes. ASMs do not cure epilepsy, but most seizures can be prevented by taking medication regularly once or more a day. For approximately 70% of people with epilepsy, medication makes it possible to obtain seizure control and live a normal, active life, free of seizures. The remaining 30% of people will continue to have seizures, with the medication acting to reduce the severity and/or frequency of seizures.

Communication plan: A plan developed by the Early Learning Victoria centre that provides information to all staff, families and children about epilepsy and seizures and the centre’s epilepsy and seizure management policy.

Emergency epilepsy medication: Medication that has been prescribed for the treatment of prolonged seizures or a cluster of seizures. The most common type of emergency medication prescribed is buccal or intranasal Midazolam. Medication information is included in a child’s Emergency Medication Management Plan, and this must be kept up to date. Only staff who have received child-specific training in the emergency administration of Midazolam can administer this medication.

Emergency Medication Management Plan: Completed by the prescribing doctor in consultation with the child and/or their parent/carer. This medication plan must be attached to the child’s Epilepsy Management Plan, which has been signed by the child’s treating doctor. The preferred template to be used by the prescribing doctor can be found at epilepsyfoundation.org.au

Epilepsy: A neurological disorder marked by sudden recurrent (2 or more) episodes of sensory disturbance, loss of consciousness or convulsions associated with abnormal electrical activity in the brain.

Epilepsy Management Plan: Designed to help people recognise when seizures are occurring and gives clear directions about appropriate first aid. The plan is developed by the person who has the most knowledge and experience of the child’s epilepsy and seizures and should be less than 12 months old. The management of epilepsy requires a team approach, and the plan should be reviewed and signed by the child’s treating doctor. An Epilepsy Management Plan and Support Package has been designed by the Epilepsy Foundation.

Epileptic seizures: Epileptic seizures are caused by a sudden burst of excess electrical activity in the brain resulting in a temporary disruption in the normal messages passing between brain cells. Seizures can involve loss of consciousness, a range of unusual movements, odd feelings and sensations or changed behaviour. Most seizures are spontaneous and brief. However, multiple seizures, known as ‘seizure clusters’, can occur over a 24-hour period.

Focal (previously called ‘simple partial’ or ‘complex partial’) seizures: Focal seizures start in one part of the brain and affect the area of the body controlled by that part of the brain. The symptoms experienced will depend on the function that the focal point controls (or is associated with). Focal seizures may or may not cause an alteration of awareness. Symptoms are highly variable and may include lip smacking, wandering behaviour, fiddling with clothes and feeling sick, ‘edgy’ or strange. Focal seizures where a person has full awareness were previously called ‘simple partial seizures’. Focal seizures where a person has an altered sense of awareness were previously called ‘complex partial seizures’. Focal seizures can progress into a generalised seizure (see below).

Generalised seizure: Both sides of the brain are involved, and the person will lose consciousness. A tonic-clonic seizure is one type of generalised seizure.

Ketogenic diet: A high fat, low carbohydrate, restricted-calorie diet that may be prescribed as additional therapy. This is an effective therapy for some children, although its mechanisms are not well understood. When introducing this diet, a child is usually hospitalised, as such radical dietary changes have the potential to cause serious problems for the child. Once the child is stabilised on a ketogenic diet, they can return home, with the diet managed by their family.

Midazolam: Midazolam belongs to a group of pharmaceuticals called benzodiazepines. Its main purpose is as a sedative or hypnotic, and it is used for medical and surgical procedures. In epilepsy, midazolam is used for emergency management of seizures, as it can stop the seizures quickly. Once absorbed into the blood, Midazolam travels to the brain, attaching to brain receptors that control electrical impulses that are firing at an unusually rapid rate. Midazolam also works by relaxing muscles, which is particularly beneficial in many types of seizures. The effects of Midazolam should occur rapidly.

Not everyone living with epilepsy requires emergency medication, but for a small group of people whose seizures are difficult to control, or for people who are isolated from emergency care, Midazolam is an excellent medication. It is most commonly administered buccally (inside cheek) or intranasally.

Midazolam is fast-acting and can be easily administered by family and carers in a variety of settings. Only staff specifically trained to the requirements of a child’s Emergency Medication Management Plan can administer Midazolam.

Midazolam kit: An insulated container with an unused, in-date Midazolam ampoule/s, a copy of the child’s Emergency Medication Management Plan and Epilepsy Management Plan (which includes a picture of the child), and telephone contact details for the child’s families, doctor/medical personnel and the person to be notified in the event of a seizure requiring administration of Midazolam if families cannot be contacted. Midazolam must be stored away from light (cover with aluminium foil), and in temperatures below 25ºC.

Non-epileptic seizures (NES): Also known as dissociative seizures. There are 2 types of non-epileptic seizures:

organic NESs, which have a physical cause
psychogenic NESs, which are caused by mental or emotional processes.

Seizure record: An accurate record of seizure activity, which is important for identifying any seizure patterns and changes in response to treatment.

Seizure triggers: Seizures may occur for no apparent reason, but common triggers include forgetting to take medication, lack of sleep, other illness, heat, stress/boredom, missing meals and dehydration. Flashing or flickering lights can trigger seizures in about 5% of people living with epilepsy.

5. Authorisations and review

This policy is the responsibility of Early Learning Victoria. Contact: ELV@education.vic.gov.au

It was approved by the CEO, Early Learning Victoria, Department of Education on 29 November 2024.

Early Learning Victoria regularly reviews its policies and procedures. This policy is due for review on 29 November 2026 unless changes in legislation or Department of Education policy require it to be reviewed sooner.

Reviewed by Director, Strategy and Planning, Early Learning Victoria

Education

Updated 9 May 2025