The Epilepsy Nurses Association (ESNA) is this month launching new training guidelines for professional carers administering buccal (ormomucosal) midazolam for epilepsy patients in the community.

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

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

The 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 intervention while demonstrating the need for awareness, training and consistent review of epilepsy knowledge and protocol.

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

Phil Tittensor, Consultant Nurse for the Epilepsies based at the Royal Wolverhampton NHS Trust, said that with one in every 103 people are affected by epilepsy in the UK, a prevalence that is expected to rise.

“Epilepsy is a serious neurological condition that can affect anyone,” said Phil, “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.

He continued to say that: “The new ESNA guidelines are intended to address individual training needs for the safe administration of buccal midazolam and to be used by employing organisations to benchmark their services and ensure quality. Combined with the unique online assessment programme, we have a toolkit which boosts treatment knowledge, particularly around the care protocols of administering emergency medication.”

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

Dr Rohit went on to say that: “Epilepsy for some, is a lifelong condition and inherent to it is the risk of ‘Status Epilepticus’ ie when seizures do not stop, or one seizure follows another without the person recovering in between and lasting longer than usual. This is one of the leading causes of not only epilepsy-related deaths but also on-going ill health.

Erica Chisanga, Consultant Nurse,Epilepsies at Cambridge University Hospital further stated: “Ideally anyone who has had status epilepticus in the last 12 months should be prescribed Midazolam with consideration to be given to those with unstable epilepsy with prolonged seizures that significantly impact their quality of life.”

The ESNA best practice guidelines for training professional carers in the administration of buccal midazolam can be accessed via the Virtual College website The online epilepsy assessment tool takes approximately 15 minutes to complete and costs just £5 + VAT per person. Users are required to refresh by retaking the programme every two years.

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

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