Epilepsy Foundation 130SRP/PAB1216 2023-2025 free printable template

SEIZURE ACTION PLAN (SAP) Birth Date:Name: Address:Phone:Emergency Contact/Relationship:Phone:Seizure Information Seizure TypeHow Long It LastsHow OftenWhat HappensHow to respond to a seizure (check

How to fill out seizure action plan template form

How to fill out Epilepsy Foundation 130SRP/PAB1216

1. Gather personal information: Include your name, address, and contact details.
2. Provide medical history: Fill in information about your epilepsy diagnosis, treatment history, and any other relevant medical conditions.
3. List medications: Document all medications you are currently taking, including dosage and frequency.
4. Fill out seizure details: Describe the types and frequencies of seizures you experience.
5. Include emergency contacts: Provide names and contact information for individuals to be reached in case of an emergency.
6. Sign and date the form: Ensure you attest to the information provided by signing and dating the document.

Who needs Epilepsy Foundation 130SRP/PAB1216?

1. Individuals diagnosed with epilepsy who wish to access support and resources from the Epilepsy Foundation.
2. Caregivers and family members of people with epilepsy who need guidance and assistance.
3. Healthcare providers seeking to understand their patients' needs better.

People Also Ask about seizure action plan sample

What is the priority action for a patient experiencing a seizure?

The priorities when caring for a patient who is seizing are to maintain a patent airway, protect the patient from injury, provide care during and following the seizure and documenting the event in the health record.

What should be the first nursing action for patient having seizure?

These are general steps to help someone who is having any type seizure: Stay with the person until the seizure ends and he or she is fully awake. Comfort the person and speak calmly. Check to see if the person is wearing a medical bracelet or other emergency information. Keep yourself and other people calm.

How do you describe a seizure in nursing?

A seizure is an abnormal, unregulated electrical discharge that occurs within the brain's cortical gray matter and transiently interrupts normal brain function; a seizure typically causes altered awareness, abnormal sensations, focal involuntary movements, or convulsions (widespread violent involuntary contraction of

How do you describe a seizure like activity?

A staring spell. Uncontrollable jerking movements of the arms and legs. Loss of consciousness or awareness. Cognitive or emotional symptoms, such as fear, anxiety or deja vu.

How do you document seizure activity?

Documentation of initial medical history and physical should include the date of seizure onset, type and frequency of seizures, description of typical seizures, previous antiepileptic drugs (AEDs) used, and the date of the last seizure.

How do you code seizure like activity?

ICD-10 code R56. 9 for Unspecified convulsions is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .

What should be included on a seizure chart?

Before the seizure How did the seizure start? If known, when the seizure started, was the person awake or asleep? Was the person restless or did they cry out before the seizure started? Was there any trigger for the seizure (such as feeling tired or stressed)?

What should you document about a seizure?

Before the seizure If known, when the seizure started, was the person awake or asleep? Was the person restless or did they cry out before the seizure started? Was there any trigger for the seizure (such as feeling tired or stressed)? What position were they in when the seizure happened or when they were found?

How do you code seizure like activity in ICD-10?

2023 ICD-10-CM Diagnosis Code R56. 9: Unspecified convulsions.

What 5 things should you look for to identify a seizure?

What are the symptoms of a seizure? Staring. Jerking movements of the arms and legs. Stiffening of the body. Loss of consciousness. Breathing problems or stopping breathing. Loss of bowel or bladder control. Falling suddenly for no apparent reason, especially when associated with loss of consciousness.

What should be included in a seizure diary?

Record times and dates of seizures and how they affected you. Add other information such as details of your medical team, the types of seizures you have and any medication changes.

What is included in a seizure action plan?

A Seizure Action Plan contains the essential information school staff may need to know in order to help a student who has seizures. It includes information on first aid, parent and health care provider contacts, and medications specifically for that child.

What is included in seizure precautions nursing?

RN *PRECAUTIONS TAKEN TO CONTROL SEIZURE* • Identify and avoid precipitating factors that could lead to a seizure. Assess patient for any reactions to anticonvulsant medications or signs of toxicity and report immediately. Maintain patent airway to a medical emergency. Place oral airway when possible.

What is the code for seizure?

If you document the word “seizure”, the patient will be coded with R56. 9, unspecified convulsions, even if you meant that the patient has epilepsy. If you document “seizure disorder” or “recurrent seizures”, the patient will be coded with G40.

What does a seizure action plan include?

A Seizure Action Plan contains the essential information school staff may need to know in order to help a student who has seizures. It includes information on first aid, parent and health care provider contacts, and medications specifically for that child.

How do you record seizure activity?

Write down what happened as soon as you can. Include as much information as possible about the following areas: BEHAVIOR BEFORE THE SEIZURE - what was the person doing at the time of event, change in mood or behavior hours or days before, 'warning' or 'aura' shortly before event.

How do you describe seizure activity?

Seizures symptoms vary and can include a sudden change in awareness or full loss of consciousness, unusual sensations or thoughts, involuntary twitching or stiffness in the body or severe stiffening and limb shaking with loss of consciousness (a convulsion.)

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What is Epilepsy Foundation 130SRP/PAB1216?

Epilepsy Foundation 130SRP/PAB1216 is a form used by the Epilepsy Foundation for reporting specific data and information related to epilepsy services and patient care.

Who is required to file Epilepsy Foundation 130SRP/PAB1216?

Organizations and healthcare providers that offer epilepsy-related services and support are typically required to file the Epilepsy Foundation 130SRP/PAB1216.

How to fill out Epilepsy Foundation 130SRP/PAB1216?

To fill out the Epilepsy Foundation 130SRP/PAB1216, you must provide detailed information in the specified sections regarding the services provided, patient demographics, and outcomes associated with the care given.

What is the purpose of Epilepsy Foundation 130SRP/PAB1216?

The purpose of the Epilepsy Foundation 130SRP/PAB1216 is to collect standardized information that helps in monitoring and enhancing the quality of epilepsy care and services offered to patients.

What information must be reported on Epilepsy Foundation 130SRP/PAB1216?

The information that must be reported includes patient demographics, types of services rendered, patient outcomes, and any relevant statistics that reflect the effectiveness of the epilepsy services.