Posted By David c Wilson
Dear All,
I have been asked to carry out a risk assessment for a colleague suffering from epilepsy 2. Could anyone please advise me of the main hazards in a office environment? Also what would be the acceptable control measures?
Also if the fire alarm activates & they have a seizure what controls do we need to evacuate her from the 3rd floor?
Many thanks,
David.

Posted By Adam Worth
OK

A quick reply for now...

Main Hazards

Most people who suffer from epilepsy have warnings that a fit is amount to occur.

This means that noramlly (not always) they can remove them selves from immidiate danger and at least lie down.

Obvious hazards are hitting their head when they fall.

(See the latest First aid manual for advice)
Most people who fit regularly will only fit for a short time. treatment is as simple as ensuring the casualty is not in danger, protecting their airway and head. It's important to offer lots of reassurance and if it's a first fit or if the fit continues for longer than normal or longer than 5 mins an ambulance should be called

(remember fitting can be embarrassing and the modesty of the person should be paramount. Ensure you have a quiet area where the person can recover and I'd also consider moving people out of the office / immediate area whilst the person is fitting)

In terms of first aid - I would ensure a person trained to FAW standard in always present
I would also provide blankets (warmth and to stop person hitting head)

In terms of evacuation in a fire - How often do you have a fire?
How often does the person fit?

I'd say it's not likely that this is going to happen. I don't have enough info to recommend on this one but if you go for evacuation stretcher etc, you'll need to train people, + it's very hard to move a fitting person (and dangerous)only ever do it if you really really have to!

If your concerned contact the ambulance service or SJA or a Doctor for advice

Posted By Adam Worth
right
I've got a bit more time and decided to play. This is a guide only. I have no idea what the real circumstances are but wanted to ensure you can see how to assess this...

I hope the first aid bit has been answered, it's all basic advice that will be covered in a FAW course.

the interesting bit is the bit about evacuation.

You need to assess this risk carefully

Factors to consider

1. Potential for harm
(assume 3 deaths - Fitting party + 2 first aiders in fire)

2. How often does the fire alarm sound in anger (Assume 1/year)

3. How often does the person fit
(Assume 1/month)

4. Can the alarm trigger a fit
(assume yes)

5. What layers of protection are already in place
- Fire doors
- Fire Extinguishers

The Maths suggest that 8% of the time there is fire alarm in anger the person will be fitting!

if I did this as a functional safety assessment at work it would imply we needed to add another layer of protection redcucing risk by a factor 10 to 100/year (if I'm optimistic :))

The difficulty comes as you can't really move a fitting casualty!

You may consider a refuge area to which the casualty could be moved?

if fits are short you may consider a carry chair after the fit - Beware of second fit!

I'd appreciate other input on this. Its much more complicated than it first appears.

Posted By Adam Worth
Maths aside

I just spoke to some Ambulance crew friends...

They agree, do not try to move a fitting patient on a carry chair or stretcher.

The best thing to do in anger is to drag the casualty out,
Two people each side - lift under the arms - drag.

Oxygen is a useful addition to your first aid kit, but not essential.

I'll review my Maths :) That's what comes with trying to work and post at the same time. (I was trying to quickly justify controls)

So that now answers all questions

Posted By Mir-cat
With regard to the epilepsy, I agree with other comments and would add - speak to the person to ascertain the type of trigger, how frequently they occur etc. This will give you some idea of the FA@W issues. I have a friend who suffers with epilepsy and she has had sudden seizures without warning. I would also add that if they seem to go into another fit soon after coming out of the first - my friends advice to me after trying to give her some of her medication after the 2nd fit was "if I go a third one - call an ambulance". It may be you would choose to call an ambulance sooner, but my friend hated being in hospital and was fed up with people who didn't understand the condition ringing at the first instance when if left she would have come out of it on her own! Again I suggest - speak to the person.

With regard to the fire alarm issue, I have just spoken to a colleague who is ex-fire fighter who advises if the alarm were to activate while they are fitting, remove them to the area designated as a 'refuge' in your PEEP (Personal Evacuation & Egress Plan - which is necessary for each 'disabled' person as required in the DDA) or if there is not a designated room/area then on a safeguarded stairway. One person should remain with them and the building management and the fire service (on their arrival) should be informed of their location immediately.

I suspect there will be other opinions on this (I am assuming it is not the Towering Inferno as the fire system should give sufficient warning to allow people to evacuate).

Hope this helps and I will be interested in others views on this

Posted By Seth
As a fellow epilepsy sufferer, I agree with all points made by Bob. One thing that I think needs reinforcing (no-one will know the feeling if they don't suffer from the condition) is that the recovery period is extremely unpleasant for the sufferer. Due to the brain, in effect, short circuiting, the casualty can suffer from paralysis, confusion, unable to speak, memory loss to name but a few. I think it is essential that you speak to the person in question as they will have detailed information on their specific type of epilepsy. Once again, it is so important that you are aware of the unpleasantness and potential embarrassment that an attack at work can cause.
If you require any further info please contact me.
I apologise if I seem to be on my soapbox but this is an issue that is close to my heart.

Best regards

Seth

Posted By David c Wilson
Thanks again, especially Adam & Mir-Cat. Information from the sufferers and Ambulance crews are invalueable. Anybody else had or can relate to an experience that might be relevant to a Risk Assessment?

Posted By David c Wilson
Andy,
You can't beat actual hands on experience - thank you for your points.
I think asking whether she wants to go home or hospital is quite right.
You are also correct when you say that you cannot rely on the fire service anymore. You have to make your own emergency plan to deal with all scenarios.
Best Regards.