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New guidelines for carers administering epilepsy emergency medication launched

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New guidelines for carers administering epilepsy emergency medication launched

This month, the Epilepsy Nurses Association (ESNA) is launching new, best practice training guidelines for professional carers administering buccal (oromucosal) midazolam, emergency medication for people with epilepsy, in the community.

The guidelines, launched on 12 June, are being introduced alongside an easy-to-use online assessment tool to ensure a standard knowledge check can be undertaken effectively, following recommended training for professionals who are caring for people with epilepsy in healthcare and private care settings.

The guidelines will support best practice when training carers who are overseeing the use of buccal midazolam for the treatment of prolonged seizures. The guidelines replace the Joint Epilepsy Council (JEC) guidelines on the use of buccal midazolam.

ESNA and latest guidelines

ESNA is an organisation formed by nurses with an interest in epilepsy. Most ESNA members support or complete training for buccal midazolam to ensure core abilities are up to date and patient safety is protected.

ESNA's latest guidelines, produced in collaboration with the International League Against Epilepsy (ILAE) and the Royal College of Psychiatrists (RCPsych), outline important safety standards for first aid involvement whilst demonstrating the need for awareness, training and consistent review of epilepsy knowledge and practice.

To support the implementation of the guidelines, award-winning UK digital experts, Virtual College, have created an online assessment tool to ensure best practice is maintained in social care organisations when administering buccal midazolam.

Expert opinions

Phil Tittensor, Consultant Nurse for the Epilepsies based at the Royal Wolverhampton NHS Trust, said that there are concerns over incorrectly administered medication such as buccal midazolam. Therefore, the need to keep staff - from healthcare assistants to support workers, up to date with best practice is essential.

“Epilepsy is a serious neurological condition that can affect anyone, at any age and from any walk of life so management is absolutely key – not only in healthcare professionals but in non-professional carers who may be found working in social settings, residential homes and working with those experiencing learning difficulties,” he explained.

Dr Rohit Shankar Consultant Psychiatrist, and Honourable Associate Clinical Professor at Exeter Medical School, says the latest guidelines and assessment tool have the potential to save lives by teaching and informing those caring for and training carers of people with epilepsy.

“There is also the cost burden to the NHS, particularly in emergency care. Simple solutions to manage deterioration and reduce the ‘slide to status’ do exist which are both clinically and cost effective. However, the lack of up-to-date structured guidance in this area for the last few years has increased concerns of vulnerable people with epilepsy being failed and the potential increased risk of treatment-related harm delivered by poorly experienced trainers. Guidance such as these released by ESNA will save lives.”  

More information:

The ESNA guidelines for administering buccal midazolam can be accessed via the Virtual College website The online epilepsy assessment tool takes approximately 15 minutes to complete and costs £5 + VAT per person. Users are required to retake the programme every two years.

For more information about the new guidelines and online assessment tool, please contact