Author Topic: Epilepsy and public seizures (Read 1054 times)

eskimo2 · « **Reply #15 on:** November 20, 2006, 05:37:27 PM »

When I was in college in Hawaii I saw a homeless man fall into a seizure while crossing a street. He was thrashing his head on the pavement and scraping it up and bleeding. I stuffed my coat under his bloodied head to keep it from getting worse; it helped. I’d hope that someone would do that for me or a loved one if we were in that situation.

Gunthr · « **Reply #16 on:** November 21, 2006, 07:57:21 AM »

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If he didn't have an airway, there was nothing any non-EMT or medic could have done, anyway.

All anybody had to do was tilt the poor guy's head back. He went from cyanotic to pink once that was done. Anyone could have done it.

deSelys · « **Reply #17 on:** November 21, 2006, 08:43:39 AM »

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Originally posted by Gunthr
All anybody had to do was tilt the poor guy's head back. He went from cyanotic to pink once that was done. Anyone could have done it.

You can't force his head back or his jaw open during the seizure. You have to stay clear and wait for the erratic and violent movements to stop. Don't try to block his flailing arms or legs neither, both of you can be injured by trying so.

Gunthr · « **Reply #18 on:** November 21, 2006, 10:08:58 AM »

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You can't force his head back or his jaw open during the seizure. You have to stay clear and wait for the erratic and violent movements to stop. Don't try to block his flailing arms or legs neither, both of you can be injured by trying so. -DeSelys

You need to monitor the airway during seizures. If there is an airway present, you don't have to do anything - providing the immediate environment is safe. If there is no airway, you need to help the victim right away. It is as easy as tilting the head back.

EMERGENCY FIRST-AID TREATMENT

* Protect the person from injury. Clear the area of furniture or other objects that may cause injury from falls during the seizure.
* Do not attempt to force a hard object (such as a spoon, or a tongue depressor, etc.) between the teeth. You can cause more damage than you can prevent by doing this!
* Do not attempt to restrain or hold the person down during the seizure.
* Protect the person from inhaling vomit or mucus. Turn the person to the side if vomiting occurs. Keep the person on his or her side while sleeping after the seizure is over.
* If the person having a seizure turns blue or stops breathing, try to position the head to prevent the tongue from obstructing the airway. Breathing usually starts on its own once the seizure is over.
* CPR or mouth-to-mouth breathing is rarely needed after seizures and cannot be performed during the seizure.
* Repeated or prolonged seizures without regaining consciousness or returning to normal behavior between them (status epilepticus) may cause severe lack of oxygen in the body. This an emergency situation requiring immediate professional assistance!

http://www.nlm.nih.gov/medlineplus/ency/article/000695.htm

deSelys · « **Reply #19 on:** November 21, 2006, 03:53:29 PM »

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Originally posted by Gunthr
...
* Do not attempt to force a hard object (such as a spoon, or a tongue depressor, etc.) between the teeth. You can cause more damage than you can prevent by doing this!
* Do not attempt to restrain or hold the person down during the seizure.
* Protect the person from inhaling vomit or mucus. Turn the person to the side if vomiting occurs. Keep the person on his or her side while sleeping after the seizure is over. +++
* If the person having a seizure turns blue or stops breathing, try to position the head to prevent the tongue from obstructing the airway. Breathing usually starts on its own once the seizure is over. +++
* CPR or mouth-to-mouth breathing is rarely needed after seizures and cannot be performed during the seizure.
...

+++ This is nicely said but in most cases you just CAN'T do anything during the grand mal except making room around the person (who is on the ground trashing and flailing...). You have to wait for the seizures to stop.
Only trained people will be able to spot the onset of a grand mal and force something between the teeth BEFORE the seizure starts.

Gunthr · « **Reply #20 on:** November 21, 2006, 04:17:08 PM »

In every case in which a seizure victim is not breathing, an attempt must be made to give them an airway.

Most often a very simple repositioning of the head is all that is necessary.

deSelys · « **Reply #21 on:** November 21, 2006, 05:32:19 PM »

Are you first-aid trained, Gunthr? There is no 'very simple' repositioning of the head during a grand mal seizure because of the violent jerking motions.
The best way is to wait that it ends (normal end of the seizure or victim passing out by lack of oxygen) and then immediatly check airways and provide air and CPR if needed.

Slash27 · « **Reply #22 on:** November 21, 2006, 05:54:33 PM »

If the patient appears to be not breathing, repositioning of the head is fine and should be done. Its not the perfect solution but it is the proper thing to do. If they are having full body seizures, there is a risk of getting injured so use common sense. Something else to keep in mind is why are they seizing? Is it a condition or is it from an injury? If the patient fell and had suffered a head injury there is also the risk of a c-spine injury. Keep that in mind before trying to move the person.

Standard procedure is to remove items from around the patient to prevent them from injuring themselves and wait for fire/ems or first responders to arrive. Doing things like what eskimo stated are good common sense. That goes along way in situations like that.

FYI, no one should force anything in a seizure patients mouth. Before or during the seizure. No one wants a mouth full of broken teeth.

Gunthr · « **Reply #23 on:** November 21, 2006, 08:35:23 PM »

I'm trained, deSelys.

majic · « **Reply #24 on:** November 21, 2006, 09:45:44 PM »

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Originally posted by Gunthr
I'm trained, deSelys.

Color me curious. How on earth do you simply tilt the head back on a person going through a seizure? (I have never witnessed a seizure, but aren't head and neck movements common?)

Slash27 · « **Reply #25 on:** November 21, 2006, 10:52:05 PM »

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Originally posted by majic
Color me curious. How on earth do you simply tilt the head back on a person going through a seizure? (I have never witnessed a seizure, but aren't head and neck movements common?)

Tilting the head back is not going to be effective 100% of the time in a seizure patient obviously. But if you can, do it if its needed. Or the best you can get done.

Chairboy · « **Reply #26 on:** November 21, 2006, 10:56:39 PM »

Perfect is the enemy of good enough. He's saying that if you _can_ open an airway where one is closed and you can do it without breaking their teeth, go for it.

myelo · « **Reply #27 on:** November 22, 2006, 08:34:35 AM »

With a generalized tonic-clonic seizure (the most common type) the patient usually stops breathing during the tonic (first) phase of the seizure because of the sustained tonic contractions of all muscles, including the chest and diaphragm. They don't need CPR and they don't need anything placed in their mouth. It's anatomically impossible for a patient to "swallow their tongue." Breathing typically resumes after the seizure.

For people with epilepsy (the most common cause of seizures) you don't need to call 911 unless the seizure has not stopped within 5 minutes. People with epilepsy don't need to go to the hospital after every seizure

Slash27 · « **Reply #28 on:** November 22, 2006, 01:04:29 PM »

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Originally posted by myelo

For people with epilepsy (the most common cause of seizures) you don't need to call 911 unless the seizure has not stopped within 5 minutes. People with epilepsy don't need to go to the hospital after every seizure

With bystanders, how would they know for sure?

Red Tail 444 · « **Reply #29 on:** November 22, 2006, 01:14:47 PM »

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Originally posted by myelo
People with epilepsy don't need to go to the hospital after every seizure

In Minnesota, yes, they do.