AP has a diagnosis of Cerebral palsy, epilepsy and high tone and is non-speaking. AP has emergency medication for her seizures called buccal midazolam, AP has protocols in place for her emergency medication. Generally AP will alert staff when she is having a seizure by making a loud gasping noise.

WHEN AP HAS A SEIZURE SHE IS SUPPORTED WITH HER FIRST DOSE OF BUCCAL MIDAZOLAM 10MG AT 2 MINUTES SINCE THE START OF HER SEIZURE. THE SECOND DOSE OF BUCCAL MIDAZOLAM 10MG IS ADMINISTERED AT 12 MINUTES SINCE THE START OF HER SEIZURE. STAFF ARE TO CALL AN AMBULANCE AFTER AP HAS HAD THE SECOND DOSE OF BUCCAL MIDAZOLAM AND INFORM THEM THAT AP HAS BEEN ADMINISTERED 20MG OF BUCCAL MIDAZOLAM. IF ANITA IS HAVING CLUSTER SEIZURES AND HAS 2 OR 3 IN THE SPACE OF 30 MINUTES AND AP IS NOT RECOVERING WELL STAFF ARE TO ADMINSTER 1 DOSE OF 10MG BUCCAL MIDAZOLAM. STAFF ARE TO CLOSELY MONITOR AP FOR 5-10 MINUTES TO RECOVER AND IF AP CONTINUES CLUSTER SIZURES STAFF ARE TO CALL AN AMBULANCE AND INFORM THEM OF THE SEIZURES AP IS PRESENTING.

Anita is supported with suctioning when she is unable to bring any excess saliva up herself. Only staff who are suctioned trained can support AP with suctioning. AP is NIL-BY-MOUTH and is supported with all her medications and ensures via her PEG.

Only staff who have received PEG training are able to support Anita with medication or feeds. AP has high tone and no seated balance. AP is supported with in situ slide sheets to turn in her bed, she is supported with regular turning through the day and night and is allowed up to 4 hours a time on one side as she is high risk for pressure sores.

AP is a wheelchair user and is supported to transfer from her bed to her chair or vice versa via hammock sling and ceiling track hoist. The colours for AP sling are yellow top and yellow bottom. Her shower sling is red top and purple bottom. AP has very high tone in her arms and her legs meaning that her arms stay in the same position, when supporting with PC staff are to ask AP to “bring her arm down” so they can wash, dry and clothe.

AP has an armchair and wheelchair and is allowed up to four hours a time in her chair. After four hours AP should be supported back to her room and supported with at least one hour bed rest. Staff are to closely monitor all areas for breakdown of skin and pressure concerns and report immediately. In the morning AP is supported onto the commode and given privacy to pass a bowel movement and is then supported with her PC either shower or wash and then supported to dry and dress. If AP is on bed rest she is supported into a seated position on her bed and triangular wedges are used to ensure that she is safe and positioned well.

AP is not to be administered any medication or feed laying flat or on her side as she has high risk of aspiration.

AP has bed sides that are to be raised when she is laid on her bed to prevent her falling out her bed. AP is supported with regular pad changes four hourly throughout the day and night. AP medication times are 07:30 08:00, 11:00, 13:30, 17:30, 19:00, 20:30.