MODULE 3: Epilepsy Support and Non-medication Management 44 Call 911 or Seek Emergency Help In Any of the Following Situations  Generalized seizure that lasts longer than 5 minutes, unless otherwise noted on this form in the “When Seizures Require Additional Help” section above  2 or more seizures without recovering between seizures  If “As-needed” treatments listed on this form don’t work  Injury occurs or is suspected, or seizure occurs in water  Breathing, heart rate, or behavior doesn’t return to normal  Unexplained fever or pain that happens hours or a few days after seizure  Other emergency care needed for this person: Healthcare Contacts Epilepsy Doctor Phone Primary Care or Other Healthcare Provider Phone Preferred Hospital Phone Pharmacy Phone Parent/Guardian Signature Date Healthcare Provider Signature Date 1. Epilepsy Foundation. Seizure Response Plans 101. http://www.epilepsy.com/get-help/managing-your-epilepsy/seizure-response-plans-101. Published August 2013. 2. Epilepsy Foundation of Michigan. Community Education. http://www.epilepsymichigan.org/page.php?id=334. 2011. 3. Epilepsy Foundation. My Seizure Plan. http://www.epilepsy.com/sites/core/files/atoms/files/myseizureplan.pdf. 2007. 4. Epilepsy Foundation. Seizure Action Plan. http://epilepsy.prod.acquia-sites.com/sites/core/files/atoms/files/seizure-action-plan-pdf_0.pdf. 2008. Call 911 or Seek Emergency Help In Any of the Following Situations  Generalized seizure that lasts longer than 5 minutes, unless otherwise noted on this form in the “When Seizures Require Additional Help” section above  2 or more seizures without recovering between seizures  If “As-needed” treatments listed on this form don’t work  Injury occurs or is suspected, or seizure occurs in water  Breathing, heart rate, or behavior doesn’t return to normal  Unexplained fever or pain that happens hours or a few days after seizure  Other emergency care needed for this person: Healthcare Contacts Epilepsy Doctor Phone Primary Care or Other Healthcare Provider Phone Preferred Hospital Phone Pharmacy Phone Parent/Guardian Signature Date Healthcare Provider Signature Date 1. Epilepsy Foundation. Seizure Response Plans 101. http://www.epilepsy.com/get-help/managing-your-epilepsy/seizure-response-plans-101. Published August 2013. 2. Epilepsy Foundation of Michigan. Community Education. http://www.epilepsymichigan.org/page.php?id=334. 2011. 3. Epilepsy Foundation. My Seizure Plan. http://www.epilepsy.com/sites/core/files/atoms/files/myseizureplan.pdf. 2007. 4. Epilepsy Foundation. Seizure Action Plan. http://epilepsy.prod.acquia-sites.com/sites/core/files/atoms/files/seizure-action-plan-pdf_0.pdf. 2008. USP-DSEP1118-0053- Module 3 ©2018 UCB, Inc., Smyrna, GA 30080. All rights reserved.