Seizure First Aid
(This is the first in what will be a series of practical tips I’ve learned on my clerkships that are applicable to everyone, not just medical professionals.)
There are many types of seizures, not just the classical shaking ones you see on television. If someone should have one of these seizures, however, or another one where they fall down or lose consciousness, there’s some basic first aid guidelines, and also some myths that need to be dispelled. Use your common sense, keep the person safe, and reailze that in most cases, the seizure will end on its own. If it lasts more than 5 minutes, then you should call 911. From epilepsy.com, one of the best medical websites I’ve found for a specific disorder
- Stay calm. You’re probably more scared than the person having the seizure; they’re unconscious (for shaking seizures, know as generalized tonic-clonic seizures, as well as many others).
- Prevent injury. Make sure the person isn’t going to hit a piece of furniture with their body, knock over a glass and get cut, or grab a cord and pull an object onto themselves, etc.
- Pay attention to the length of the seizure.
- Make the person as comfortable as possible.
- Keep onlookers away.
- Do not hold the person down. You don’t need to restrain them.
- Do not put anything in the person’s mouth. There’s a big misconception that you should stick a spoon or something into a person’s mouth. They’re not going to swallow their tongue, but they may bite it.
- Do not give the person water, pills, or food until fully alert.
- If the seizure continues for longer than five minutes, call 911
- Be sensitive and supportive, and ask others to do the same.
- The person may become incontinent (soil themselves with urine or stool). This is normal.
- The person may bite their tongue or cheek, so they may have a little bloody saliva coming out of their mouths. This can look very scary, but is probably normal.
After the seizure, the person should be placed on her left side, in the recovery position. There’s a small risk of post-seizure vomiting, before the person is fully alert. The left side is better than the right because the left side has a sharper angle of the lungs, so there’s probably a slightly smaller risk of vomit going into the lungs. Therefore, the person’s head should be turned so that any vomit will drain out of the mouth without being inhaled. After the seizure, the person enters the postictal state, which is just medical lingo for post-seizure. People can be very sleepy or confused at this time, so stay with the person until she recovers (5 to 20 minutes).
As a med student doubling as an ambulance co-worker, for the benefit of readers not in the health care professions, I’d like to take the opportunity to stress the importance of ensuring open airways and free breathing when assisting people who are unconcious for one reason or another.
Seizures are not normally associated with blocking of airways and/or stoppage of breath. However, these two factors always are _the_ two most important things to consider when assisting people unable to care for themselves.
You must repeatedly monitor the unconcious person’s breathing. This can be done with your hand or your cheek 2-3 centimetres away from nose/mouth or a pocket mirror, a pair of glasses or another object of glass (observe moisture) or by making sure the chest rises and sinks. Repeat ad nauseum, until you are relieved either by the person waking up or health care professionals).
Remember, your first priority is to keep the airways free. That’s why you _never_ put anything in the mouth of an unconcious person, and that’s why, if the person vomits, you have to get it out of there (even if it’s a bit messy).