Epilepsy Awareness Information

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What is the difference between Epilepsy and a seizure?

Epilepsy is a disorder characterized by recurring seizures

A seizure is a brief, temporary disturbance in the electrical activity of the brain. This disruption results in the brain’s messages becoming halted or mixed up.

A seizure is a symptom of epilepsy

The brain is responsible for all the functions of the body, so experiences during a seizure will depend on where in the brain the epileptic activity begins and how widely and rapidly it spreads.

There are many different types of seizure and each person will experience epilepsy in a way that is unique to them.

Epilepsy Facts

  • In the UK, there are over 600,000 people with epilepsy.
  • Epilepsy is more common in children and people over 65, but anyone can develop epilepsy
  • There are over 40 types of epilepsy, so just knowing that a person ‘has epilepsy’ tells you very little information about their epilepsy and the seizures that they have.
  • Epilepsy can develop because of brain damage caused by a difficult birth, a severe blow to the head, a stroke, or an infection of the brain such as meningitis.
  • In around six out of ten people, doctors don’t know the cause of their epilepsy.
  •   (Epilepsy Action, 2013)

Classification of Seizures

Seizures can be divided into two main groups:

Generalised Seizures

Focal/ Partial Seizures

Generalised Seizure Types

¨Tonic-Clonic

¨Typical Absence

Focal/ Partial Seizures

Symptoms can last from seconds to 1 – 3 minutes can

present as:

  • mumbling or uncontrolled laughter
  • Sucking, chewing or swallowing movements
  • Plucking at or removing clothing
  • May wander around as if drunk

Management of Focal/Partial Seizures

DO

  • Stay calm
  • Guide the patient from danger
  • Stay with the patient until recovery is complete
  • Reassure and explain anything they have missed

DON’T

  • Restrain the patient
  • Act in a way that could frighten them, such as making abrupt movements or shouting at them
  • Give the patient anything to eat or drink until they are fully recovered

Tonic -Clonic Seizures

  • Most common of the generalised seizure
  • May have an aura leading into the tonic/clonic seizure
  • Lose consciousness
  • Usual duration 1-2 minutes
  • May follow on from a focal seizure

Typical Absence Seizures

  • Generally a childhood disorder
  • May look blank and stare, lasting a few seconds
  • Eye lid fluttering/blinking may occur
  • May have minor facial movements or head drop
  • Able to continue normal activity almost immediately
  • Management of Absence Seizures

DO

Record the time of day and frequency

Reassure if necessary

Repeat information that the patient may have missed

 

Seizures in a wheelchair – What should we do?

If a person with epilepsy uses a wheelchair or has mobility problems, their GP or epilepsy specialist should give them a care plan. This should include advice on how to help the person if they have a seizure. General advice about how to help someone who is having a seizure in a wheelchair.

Do:

  • Put the brakes on, to stop the chair from moving
  • Let them remain seated in the chair during the seizure (unless they have a care plan which says to move them). Moving them could possibly lead to injuries for both you and them
  • If they have a seatbelt or harness on, leave it fastened
  • If they don’t have a seatbelt or harness, support them gently, so they don’t fall out of the chair
  • Cushion their head and support it gently. A head rest, cushion or rolled up coat can be helpful
  • The person’s care plan should give advice on what to do after the seizure has finished. Eg it should say if it is safe to move them from the wheelchair to put them in the recovery position.

Don’t:

  • Restrain their movements
  • Put anything in their mouth
  • Give them anything to eat or drink until they are fully recovered
  • Attempt to bring them round

When should you call for an Ambulance?

You think the patient needs urgent medical assistance

The patient has any breathing difficulties following a seizure

It is a first seizure

The seizure continues for longer than normal

One seizure follows another without regaining consciousness

STATUS EPILEPTICUS

Usually seizures stop by themselves. However, if a seizure continues for more than 30 minutes (or one seizure follows another with no recovery in between) this is known as status epilepticus or ‘status’.

Status during a tonic clonic (convulsive) seizure is a medical emergency. For some people, missing doses of their medication can trigger status.

The emergency medication used for the treatment of status is usually a sedative

Sedative drugs have a calming effect on the brain and can stop a seizure. The point at which emergency medication is used depends on how long someone’s seizures usually last.

Emergency Treatment

There are two most commonly used emergency medications;

Rectal diazepam – is given rectally (into the bottom).

Buccal midazolam – is given into the buccal cavity (the side of the mouth between the cheek and the gum) (can terminate seizure, can prevent further seizures)

As both these drugs are sedatives, they can cause breathing difficulties so the person must be closely monitored.

Carers require specialist training to give emergency medication. It is important that every individual who is prescribed these has a written plan (or protocol) for their carers to use.

Treatment

Currently there is no cure for epilepsy. However, with the right type and dosage of anti-epileptic medication, approximately 70% of people with epilepsy could have their seizures completely controlled.

  (Epilepsy Action)

Anti Epileptic Drugs

  • These drugs make the brain less likely to have seizures by reducing the excessive electrical activity (or excitability) of the neurones  (nerve cells) that normally cause a seizure.
  • Different drugs work in different ways, but they all aim to stop seizures happening.

What might trigger a seizure?

  • Missed medication (Number 1 reason)
  • Stress/Anxiety
  • Hormonal changes
  • Dehydration
  • Lack of sleep/extreme fatigue
  • Photosensitivity
  • Drug/alcohol use

Seizure Management Plan

  • Seizure Management Plan should be in place & available agreed by:
  1. ¨Parent/carer
  2. ¨Doctor
  3. ¨patient’s Epilepsy Nurse Specialist
  • Original Copy to travel with the patient (Epilepsy Passport)
  • Updated yearly or more often if required
  • Be aware of who is responsible for first aid
  • Parent/carer should be informed of seizure ASAP
  • Record seizure

IT WILL PROVIDE:

Description of seizure

Usual duration of seizure

Trigger factors

Management of seizure

Recording Information

  • What type or types of seizures did the person have?
  • How long did their seizures last?
  • When did the seizure happen?
  • Warnings – were there any warnings before the seizure such as:
  1. a change of mood
  2. restlessness
  3. any sensations such as a ‘strange’ taste in the mouth or smelling a ‘strange’ odour, seeing spots or flashing lights or colours  
  4. a strange feeling in the stomach, weakness, numbness, tingling, ‘pins and needles’ in the arms, legs or face
  5. Any sounds such as crying out or mumbling?
  • Where there any triggers such as being tired or photosensitivity (seizures caused by flashing lights or moving patterns)?

Recording Information

Where were they and what were they doing when the seizure occurred? Were they:

  • standing, sitting or lying down
  • walking or sleeping
  • What else where they doing?
  • During the seizure;
  1. Did they fall down?
  2. Did they lose consciousness and, if so, for how long?
  3. Did their colour change such as:
  • become pale
  • become flushed
  • become blue around the mouth or face

Recording Information

  • How was their breathing?
  • After the seizure did they
  1. Recover quickly and carry on with activities?
  2. Become confused and , if so, for how long
  3. Become agitated, aggressive, restless
  4. Need to sleep and, if so, for how long?
  • Did they injure themselves and, if so, what were the injuries and how were they treated
  • How long did it take for them to recover fully?
  • How did they feel afterwards?
  • Did they need to sleep afterwards?
  • What medication are they taking? (This may be helpful if the person is taken to hospital).
  • Is there anything else that may be helpful to know about their seizures?

Further Reference 

  • The National Society for Epilepsy
  • The Brain and Spine Foundation
  • The Equality Act (2010)
  • The Equality and Human Rights Commission
  • Brain Thunders
  • The DVLA

 

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Training

Training is teaching, or developing in oneself or others, any skills and knowledge that relate to specific useful competencies. Training has specific goals of improving one’s capability, capacity, productivity and performance. It forms the core of apprenticeships and provides the backbone of content at institutes of technology (also known as technical colleges or polytechnics). In addition to the basic training required for a trade, occupation or profession, observers of the labour-market recognize as of 2008 the need to continue training beyond initial qualifications: to maintain, upgrade and update skills throughout working life. People within many professions and occupations may refer to this sort of training as professional development.

 

On job training

Some commentators use a similar term for workplace learning to improve performance: “training and development“. There are also additional services available online for those who wish to receive training above and beyond that which is offered by their employers. Some examples of these services include career counselling, skill assessment, and supportive services. One can generally categorize such training as on-the-job or off-the-job.

 

The on-the-job training method takes place in a normal working situation, using the actual tools, equipment, documents or materials that trainees will use when fully trained. On-the-job training has a general reputation as most effective for vocational work. It involves employee training at the place of work while he or she is doing the actual job. Usually, a professional trainer (or sometimes an experienced employee) serves as the course instructor using hands-on training often supported by formal classroom training. Sometimes training can occur by using web-based technology or video conferencing tools.

 

Simulation based training is another method which uses technology to assist in trainee development. This is particularly common in the training of skills requiring a very high degree of practice, and in those which include a significant responsibility for life and property. An advantage is that simulation training allows the trainer to find, study, and remedy skill deficiencies in their trainees in a controlled, virtual environment. This also allows the trainees an opportunity to experience and study events that would otherwise be rare on the job, e.g., in-flight emergencies, system failure, etc., wherein the trainer can run ‘scenarios’ and study how the trainee reacts, thus assisting in improving his/her skills if the event was to occur in the real world.

 

Examples of skills that commonly include simulator training during stages of development include piloting aircraft, spacecraft, locomotives, and ships, operating air traffic control airspace/sectors, power plant operations training, advanced military/defence system training, and advanced emergency response training.

Off-the-job training method takes place away from normal work situations — implying that the employee does not count as a directly productive worker while such training takes place. Off-the-job training method also involves employee training at a site away from the actual work environment. It often utilizes lectures, seminars, case studies, role playing, and simulation, having the advantage of allowing people to get away from work and concentrate more thoroughly on the training itself. This type of training has proven more effective in inculcating concepts and ideas.

Many personnel selection companies offer a service which would help to improve employee competencies and change the attitude towards the job. The internal personnel training topics can vary from effective problem-solving skills to leadership training.

 

Training and development involves improving the effectiveness of organizations and the individuals and teams within them.[1] Training may be viewed as related to immediate changes in organizational effectiveness via organized instruction, while development is related to the progress of longer-term organizational and employee goals. While training and development technically have differing definitions, the two are oftentimes used interchangeably and/or together. Training and development has historically been a topic within applied psychology but has within the last two decades become closely associated with human resources management, talent management, human resources development, instructional design, human factors, and knowledge management.[1]

 

Practice

Training and development encompass three main activities: training, education, and development.

 

The “stakeholders” in training and development are categorized into several classes. The sponsors of training and development are senior managers. The clients of training and development are business planners. Line managers are responsible for coaching, resources, and performance. The participants are those who actually undergo the processes. The facilitators are Human Resource Management staff. And the providers are specialists in the field. Each of these groups has its own agenda and motivations, which sometimes conflict with the agendas and motivations of the others.

Especially in the last couple decades, training has become more trainee-focused, which allows those being trained more flexibility and active learning opportunities. For example, these active learning techniques include exploratory/discovery learning, error management training, guided exploration, and mastery training. Typical projects in the field include executive and supervisory/management development, new-employee orientation, professional-skills training, technical/job training, customer-service training, sales-and-marketing training, and health-and-safety training. Training is particularly critical in high-reliability organizations, which rely on high safety standards in order to prevent catastrophic damage to employees, equipment, or the environment (e.g. nuclear power plants, operating rooms).

 

Benefits

Training has been used in organizations for the past several decades. Although training and development requires investments of many types, there are cited benefits to integrating training and development into organizations:

  • Increased productivity and job performance
  • Skills development
  • Team development
  • Decreasing safety-related accidents

However, if the training and development is not strategic and pointed at specific goals, it can lead to more harm than good. Needs assessments, especially when the training is being conducted on a large-scale, are frequently conducted in order to gauge what needs to be trained, how it should be trained, and how extensively. Needs assessments in the training and development context often reveal employee and management-specific skills to develop (e.g. for new employees), organizational-wide problems to address (e.g. performance issues), adaptations needed to suit changing environments (e.g. new technology), or employee development needs (e.g. career planning).

 

The degree of effectiveness of training and development programs can be predicted by the needs assessment and how closely the needs were met, the execution of the training (i.e. how effective the trainer was), and trainee characteristics (e.g. motivation, cognitive abilities). Effectiveness of training is typically done on an individual or team-level, with few studies investigating the impacts on organizations.

 

 

Compliance training refers to the process of educating employees on laws, regulations and company policies that apply to their day-to-day job responsibilities. An organization that engages in compliance training typically hopes to accomplish several goals: (1) avoiding and detecting violations by employees that could lead to legal liability for the organization; (2) creating a more hospitable and respectful workplace; (3) laying the groundwork for a partial or complete defence in the event that employee wrongdoing occurs despite the organization’s training efforts; and (4) adding business value and a competitive advantage.[1]

Organizations offer their employees compliance training on a wide range of topics, including workplace discrimination and harassment, dealings with competitors, insider trading, protecting trade secrets, records management, bribery and kickbacks, etc. Typically, most or all of these compliance topics are addressed in an organization’s Code of Conduct, and the organization may offer employees annual or bi-annual Code of Conduct training in lieu of requiring employees to take multiple individual training programs.

 

Types of Compliance Training

There are many industries that require highly specialized and unique compliance training. Some of these industries include the medical industry, banking industry, pharmaceutical industry and the food and beverage industry.

Who is required to have compliance training?

Companies in all business sectors are under pressure to demonstrate that their employees are trained in laws and regulations, and internal policies, that pertain to their roles. Most notably, companies in the financial and healthcare sectors – who face stringent regulations – and publicly regulated companies have taken the lead by instituting firm-wide compliance training programs. For example, WalMart would be required to train their employees on sexual harassment, data security, anti-harassment, and more.

For financial institutions, the key compliance training topics are anti money laundering, sanctions, and insider dealing (market abuse in the EU).

 

Process

Compliance training can be performed in-house by compliance training specialists, or hired out to consultant firms. Some compliance training is done online.

Penalties for non-compliance

While this is entirely tied to the realm of compliance that is being considered, the penalties can range from a Fine, through the seizure of company assets, to jail time for executives of the company at fault.

 

References – This information was obtained via;

https://en.m.wikipedia.org/wiki/Compliance_training

https://en.m.wikipedia.org/wiki/Training_and_development

https://en.m.wikipedia.org/wiki/Training