SEIZURE PROTOCOL

SEIZURE PROTOCOL

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Name: DOB:

Diagnosis:

Emergency Contact: PHONE:

__name_______________s MEDICAL History:

MEDICATIONS:

HISTORY: ______name________ has a history of Petit Mal seizures, display by                      for

        Seconds/minutes.

Grand Mal seizures display as follows:

NOTE:

If                        has a seizure lasting longer than             minutes:

• Call: parent:  name:                                 phone: _________________________
•   Call 911 if seizure lasts longer than 5 minutes and no rescue medications are available.