First Aid Preparedness Patsy Ramey, RN, BSN Clinical Resource Nurse Epilepsy Division
Epilepsy Basics Seizures are a bit like an electrical brainstorm. The chaos that occurs in the brain during a seizure can prevent that person from: Correctly interpreting and processing incoming sensory signals Visual: changes in perception or seeing things that aren t actually there (hallucinations) Somatosensory: strange smells or tastes, burning, tingling, numbness in a body part Auditory: distorted hearing or even hallucinations Controlling the body s muscles (causing the uncontrolled movements and/or falling)
Potential Effects on the body Mental confusion Paranoia/fear Aphasia or inability to speak Inability to move an extremity: Todd s Paralysis Muscle strain Headache Exhaustion Acute Physical injury cut/break/burn
Basic Care for all seizure types Keep calm and reassure others that may be nearby Assure the safety of the person experiencing the seizure Clear the area of any hard or sharp surfaces If they are walking around, try to gently guide them away from areas of risk such as stairways or traffic If they are convulsing on the floor attempt to pad the floor with something soft
Basic Care for all seizure types, cont. Time the seizure with your watch. A few seconds while watching someone seize can seem like hours! Loosen any articles around the neck, such as ties or shirt collars, that might make breathing difficult Do not put anything into the person s mouth doing so is actually dangerous to the person. It is not possible for them to swallow their tongue!
Basic Care for all seizure types, cont. When it is possible turn him/her gently on their side. This allows gravity to assist in clearing the airway. Then WAIT! This is often the hardest part. Allow the person to return to his/her baseline or normal behavior before trying to move them. In a calm quiet tone reassure the person that they are safe, that there is someone with them and that someone will stay with them until they are okay.
The Do Not List Don t panic Don t try to stop the person from wandering Don t restrain or hold down Don t put anything in their mouth Don t shake or shout Don t leave them unattended until the seizure has stopped Don t worry you re doing great just being there!
First Aid that might be needed! Everyone should learn basic first aid and CPR. It is rare for the seizure patient to fail to restart breathing following a seizure. A bluish or gray, pale skin color, is not unusual during a seizure. Breathing may be extremely shallow, noisy and gurgling, gasping or deep. If however the individual does not start breathing following the seizure, then you need to provide two breaths and then reevaluate. [Remember no panicking!] This would be an appropriate time to dial 911.
First Aid for physical injuries Bruises ICE is always recommended for initial treatment. It slows bleeding into the damaged tissue. This is true for bumps on the head also. If a booboo pack is not available; frozen vegetables are always good. Protect the skin from direct contact with ice as it can damage the skin tissue.
First Aid for physical injuries Cuts First remember: heads bleed profusely and a little bit of blood can seem like a lot! Apply pressure. Ideally a clean compress should be applied to the cut with pressure. If the injury does not occur in a place convenient to first aid equipment - improvise. Use what is available
First Aid for physical injuries Burns As long as the skin is intact, cool water is recommended to initially stop the burn. Simple burns should be cleaned and covered. More severe burns especially if they cover a large area should be evaluated by a physician.
First Aid - - not done yet! If the individual has a possible fracture. Brace and if materials aren t available or you are not comfortable with providing trained first aid. Don t move the injured area and contact 911 for emergency assistance. If there is any risk of a neck injury [especially if the individual is not able to move on their own]. Leave them just as they are and await professional caregivers.
Now to the simple stuff! Be calm and speak softly and reassuring remember the person may be confused and frightened If the individual is unable to talk or is unable to move one or more extremity again provide them reassurance. This issue should go away shortly.
What to do when the seizure is over Don t give the person anything to eat or drink until they are fully alert. If necessary, offer to call a taxi, a friend, or a relative to help the person get home safely. If the individual is known to have seizures, and they have regained consciousness, there is no need to transport them to the hospital.
What events should trigger the need to call 911!!! Seizures with jerking all over lasting longer than 5 minutes or any seizure lasting over 15 minutes is the normal time frame at which one would seek medical assistance. If the person is unknown to you and you have no way of determining if this is a first seizure.
What events should trigger the need to call 911!!! Cont. The person is pregnant, injured, or has diabetes. The seizure happened in water. The person does not begin breathing again. Consciousness does not start to return after the seizure has stopped.
How to prepare for a seizure You and your family and friends are the ones that live with the seizures from day to day. Take time to design a game plan or seizure plan so that should a seizure occur everyone is prepared to cope with it. Epilepsy.com has an excellent my seizure plan that provides a form that will help you design a care plan specific for your particular seizure type
Seizure Preparedness Seizure identification medic alert systems What others need to know: Seizure description Types of seizures that might be considered an emergency/ or if prolonged seizures are normal describe when not to transport Recovery medications or specific care [VNS]
Did you know? Saint Valentine is the patron saint of epilepsy.
Sources www.//epilepsy.com www.//netwellness.org www.//webmd.com www.epilepsyfoundation.org