Administering Buccolam

Many teachers become very apprehensive at the thought of giving buccolam. The government states that parents and head teachers must respect such concerns and not put pressure on staff to assist in treatment. We hope that by reading this advice leaflet and with support from the epilepsy specialist nurse or school nurse, you will feel more confident about making an informed decision.
By administering buccolam in schools, a child receives appropriate first aid treatment.

Seizures in children should stop within 5-10 minutes but occasionally they go on for longer.
If a single seizure or series of seizures lasts for 30 minutes or more, it is called status epilepticus. Occasionally, very prolonged seizures may harm a child. To try to prevent prolonged seizures, buccolam has been prescribed for use at home and, where appropriate, at school.

Buccolam is usually given 5- 10 minutes after the start of a seizure. The precise timing will depend on the child’s age and seizure pattern and will be decided by the child’s GP or consultant doctor. You will be given a protocol to follow.
It is important that you time the seizure rather than guess how long it has lasted so you know when to use buccolam.
It is intended to be used as a first aid measure only. Allow at least 24 hours between doses, unless admistered under medical supervision.

After a seizure a child will normally become relaxed and sleepy. He or she may be able to respond to you but may appear confused. If the child is still stiff or twitchy, even though the bigger movements have stopped, the seizure may still be continuing.

Buccolam is supplied in age-specific, pre-filled, needle-free oral syringes. The syringes are colour coded according to the correct dose. The child’s doctor will prescribe the appropriate dose. Each syringe will contain a single dose. The doctor will decide how many doses of buccolam you will be dispensed (usually between two and four).

When you are ready to administer it, try to put the child on his or her side, then:

• take a plastic tube, break the tamper-proof seal and remove the syringe
• remove and discard the red cap
• gently place the syringe into the space between the child’s teeth and cheek. Use the side closest to the floor
• once in place, slowly push the plunger down to squeeze out the medicine. Hold the child’s lips together on that side for a minute or two to prevent leakage.

If the child is on his or her back you can drip a little of the buccolam into each cheek. Remember to put the child into the recovery position as soon as you are able to do so.

No – it will take 5-8 minutes to work because it has to be absorbed into the bloodstream.

We advise you to call 999 for an ambulance as well as giving buccolam in any one of the following circumstances:

• if it is the first time the child has had buccolam
• if the seizure has not stopped five minutes after using buccolam
• if you think the child may have suffered a head injury during the seizure
• if the child appear to be having trouble breathing or there are concerns
• you have any other concerns.

No – unless the doctor has prescribed a further dose.

Buccolam may slow down a child’s breathing. If the child has a severe chest infection or other breathing problems, call 999 for an ambulance as well as giving buccolam. Buccolam can make a child sleepy, although very occasionally they may become hyperactive instead.
A small number of children may appear dazed and stare as if hallucinating after taking buccolam.

It should be stored at room temperature and out of reach of children, in a secure location that is accessible by the appropriate staff. Check the expiry date before use.

This position ensures that:

• an unconscious child maintains an open airway
• the tongue cannot fall to the back of the throat
• the head and neck remain in an extended position so that the air passage is widened
• any saliva or vomit in the child’s mouth will drain freely.

The position of the child’s limbs provides the necessary stability to keep the body propped in a safe and comfortable position.

Babies should be positioned on their side.

For further advice contact:

• GP
• health visitor
• school nurse
• paediatrician
• Epilepsy nurse specialist on 01206 745358
• Children’s Community Nursing team

www.epilepsy.org.uk