Seizures
Structural or chemical disorder of the brain which trigger sudden bursts of uncontrolled electrical discharges.
What are seizures!
episodes where body muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled shaking of the body.
Convulsions
The bystander states the best thing to do for a seizing patient is to put a towel in their mouth. You stop the bystander and warn them of this risk:
What is...
* Airway compromise - muscle contractions = bite down and choke! Remember: ABCs are key for survival!
Name 3 causes of seizures.
•
•60-70% of all cases have an unknown cause
•Epilepsy
•Stroke
•High fever in infants & children
•Drop in blood sugar (hypoglycemia)
* Other metabolic illness (hypocalcemia)
•Brain tumor
•Drug overdose
•Poisoning (lead, etc.)
•Brain infection (meningitis)
•Head trauma, such as a car accident, sport injury or shaken baby syndrome
Your patient is lying on the grass outside of dillon hall and appears very sleepy and bystanders state they saw the approximately 20 year old patient fall from standing height and "shake" for 1 minute before falling asleep on the glass. As a first aider, you perform these key actions after their seizure.
*Perform a primary survey and place casualty in recovery position. Wipe away any fluids from mouth and nose.
*Perform a secondary survey to determine if any other injuries are present. Give first aid as necessary.
*Do not be frightened if the person appears to stop breathing for a few seconds as this is common - due to muscle tension and contraction
*Allow casualty to rest or sleep after seizure.
*Look for MedicAlert™ identification.
* Give ongoing casualty care. Monitor breathing and level of consciousness
The patient says their doctor told them they have generalized seizures. What signs and symptoms would indicate this condition?
In a generalized seizure the whole brain is affected. The person loses consciousness and may have convulsions.
Signs & Symptoms (lasts 1 - 3 minutes)
•Body stiffens, fall to ground, unresponsiveness
•Seizure with thrashing usually occurs and they may bite their tongue
•Frothy saliva and/or blood at mouth
•Breathing may stop, casualty may turn purple/blue
•Loss of bladder and bowel control
•Sleepy, confused after seizure
A bystander asks for a first aider to help with an actively seizing patient. During your assessment, what information elicited from bystanders would warrant an immediate 911 call?
- child; always report to parents and call for help
BONUS (100 pts): What is a common cause of seizures in this population?
- serious injury associated with seizure - this is why a good primary is key!
- Seizure lasting over 5 minutes or 2nd seizure happened minutes between the first (WHY IS THIS CRITICAL?)
The patient is actively seizing with rhythmic contractions. You suspect they are in this phase of a tonic-clonic seizure
clonic
- tonic: LOC, muscles contract and fall down
You arrive on scene at 0800 hours and your friend with a history of epilepsy discloses they "smell burnt toast", an aura they have before they experience tonic-clonic seizures. Within 20 seconds your friend drops to the ground. What actions will you take during the active seizure?
*Perform a scene survey and apply the acronym EMCAP.
*Perform a primary survey, if able, ease the casualty to floor.
üProtect casualty from personal injury, e.g. sharp objects and glass.
* If floor is hard, place padding under the casualty’s head.
* Allow seizure to happen; do not restrain casualty.
*Do not insert anything in mouth or between teeth.
* In a patient with an unknown history, you would additionally look for Medic Alert identification.
The bystander describes the patient has appearing "out of it" and rapidly blinked for 1 minute before resuming normal activity. What seizure do you suspect the patient could have had?
Absence/ Partial Seizure
In a partial seizure only part of the brain is affected. The person may experience tingling or twitching in one area of the body.
•Eyes blink
•Slight muscle movements around mouth
•Does not fall
•May resume full activity immediately