Nasal spray bill could mean difference for epileptic students

Nasal spray bill could mean difference for epileptic students
A child being given the nasal spray medication midazolam. Courtesy Seattle Children's Hospital.

Tri-Cities mother Heather Franklin’s otherwise healthy 11-year-old son Beau suffered his first seizure in November. Doctors could find no explanation for the traumatic event, but a month later he had a second seizure.

Franklin now sends her son to school with midazolam, a medication that can be sprayed into Beau’s nose to stop his seizures. While the drug should have provided her some comfort, Franklin learned that only a school nurse is legally allowed to administer nasal spray medications in Washington, and a nurse is only at Beau’s school one day each week. If he has a seizure when the nurse is not present, school staff must call a nurse from the closest school to drive over or call 911.
Franklin decided that response plan was not good enough.

“This is not acceptable,” Franklin said. “As a parent, you don’t feel like your child is safe at school.”

Franklin shared her story with her state representative, Brad Klippert, who sponsored House Bill 1541. The legislation allows any trained person to administer nasal spray medications to students.

“I couldn’t be quiet,” Franklin said. “We can’t have children’s lives at stake.”

The law would affect many epileptic children in Washington, but it applies to all nasal spray medications, including those for allergies. 

Mukilteo resident Kim Sistek’s daughter Gabby was prescribed midazolam years ago for her daily seizures, but a nurse was only available at her school to administer the medication four days each week. On the day the nurse was off Sistek kept her daughter home from school.

“When you’re talking seizures minutes matter,” Sistek said. “The longer you’re in it the harder it can be to break.”

When responding to seizures, Dr. Rusty Novotny, director of Medical Epilepsy at Seattle Children’s Hospital, said every minute matters. He said it is important that a child having a seizure be medicated quickly to prevent serious side effects, including brain damage or death. 

“In higher-risk cases it is really critical that patients get their meds,” Novotny said.

House Bill 1541 requires that anyone who administers nasal medications first be trained on how to do so.

Franklin said the medication is so easy to use, even her 8-year-old daughter has been taught how to give it to her brother.

“I treasure the skills that nurses have,” Franklin said. “However if my daughter can administer a medication then any staff member can do it.”

Midazolam can cause respiratory problems if improperly given, but Novotny said it takes three times the recommended dosage to cause such an affect. Children’s Hospital currently offers training to anyone who could give midazolam to a child.

In Oregon, a trained volunteer can administer nasal spray medications. Epilepsy Foundation Northwest argued the law should be the same in Washington.

“No child should have adults standing around him or her debating budgets, jobs and policy while having a seizure,” said Brent Herrmann, president of Epilepsy Foundation Northwest.

Nurses have testified against the legislation because they fear that if non-medical volunteers take over their duties then their jobs will be viewed as less valuable.

Herrmann said the Epilepsy Foundation Northwest would prefer to have school nurses available all hours children are present, but because that is not the case, the organization is supporting this bill.

House Bill 1541 passed the Healthcare & Wellness Committee last week and is currently in the Rules Committee before it is voted on by the entire House.