What Is the Difference Between an SAP and ASAP?

Repeated seizures are a potential daily challenge for both adults and children with epilepsy. Managing seizures helps you have some control over your epilepsy by being prepared. One way to manage seizures is through a Seizure Action Plan (SAP), created with your healthcare provider. You can make a Seizure Action Plan and an Acute Seizure Action Plan (ASAP). Each plan helps you and your caregivers, eases fear around seizures, and has clear information and instructions.  

Do you need both plans? The two plans do have a difference in their purpose. Below is a quick guide to SAP vs. ASAP.

Seizure Action Plan (SAP)  

A Seizure Action Plan is multiple pages that includes:

• A description of your epilepsy– what your seizures look like, any triggers or warnings, how they progress, frequency, and what it looks like after a seizure (postictal state)
• Medications– seizure medication you take now or have used in the past and any allergies to medications
• Dietary therapy, if any
• Prior surgeries you’ve had for epilepsy treatment
• Implanted devices if you have one
• Contact information for healthcare providers, primary care, hospital, and pharmacy
• Education and treatment information for you and your caregivers

A Seizure Action Plan may also include results of prior evaluations and treatments. The plan is signed and dated by your healthcare provider.  

Acute Seizure Action Plan (ASAP)

An Acute Seizure Action Plan is a shortened version of a SAP. It is a quick tool to use during an acute (severe) seizure emergency, such as at the start of a seizure cluster or a prolonged seizure. The goal of the Acute Seizure Action Plan is to act early and quickly, to prevent seizure progression to the point of calling 911 or going to the hospital. The ASAP can be part of or in addition to a Seizure Action Plan.  

An ASAP includes:

• Step-by-step instructions to recognize the type of seizure and if it is unusual or atypical for you
• A visual or written description of your typical seizure pattern
• Steps for initial first aid, or to identify signs of seizure progression that show urgent treatment is needed
• If urgent treatment is needed, the specific therapy to use (for example, a magnet with an implanted VNS or rescue therapy)
• Simple instructions for how to give rescue medication
• When to call for emergency services
• Emergency contact information

An ASAP should be easy to understand to use in the “heat of the moment” for anyone at home or other community settings. The plan should also be simple to modify by a healthcare provider whenever necessary and should be signed and dated by the provider.  

Do You Have a Plan?

It is recommended that everyone with epilepsy has a thorough care plan. This includes a Seizure Action Plan and an Acute Seizure Action Plan. It is vital to have both action plans to improve safety when seizures occur.

Create or update your Seizure Action Plans today and review them with your healthcare team.

References:

1. Penovich PE and Glauser T. Seizure clusters: Practical aspects and clinical strategies to care for patients in the community. Epilepsia 2022;63 (S1) S3-S5. Doi.org/10.1111/epi.17345.
2. Penovich P, Glauser T, Becker D, Dixon-Salazar T et als. Epilepsy & Behavior 2021; 123: 108264
3. Herman ST, Detyniecki K, O'Hara K, Penovich P et al. Written seizure action plans for adult patients with epilepsy: Distilling insights from emergency action plans for other chronic conditions. Epilepsy Behav. 2023;140:109002. doi:10.1016/j.yebeh.2022.109002
4. Patel A and Becker D. Introduction  to use of a acute seizure action plan for seizure clusters and guidance for implementation. Epilepsy Behav. 2023; 140:17344. Doi.org/10.1111/epi.17344. 
5. National Institute for Health and Care Excellence. Epilepsies: diagnosis and management: Clinical guideline CG137 2021.