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  1. Seizure

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In this lesson, you'll learn how to treat an adult patient who goes into a seizure or has just come out of one.

A person can go into a seizure for too many reasons to mention. As you are concerned, why it happened isn't important. Being able to recognize that it did happen is the key.

For you to know if a seizure took place, ideally you or someone else saw the patient go into a tonic state that exhibited the following signs:

  • Hands are gripped and pointed inward
  • The patient is actively seizing
  • The patient ends the seizure in the postictal state (relaxed recovery)

How to Treat a Patient who is Actively Seizing

There are a few important things that you can do when a person is suffering from a seizure to help protect them from further harm. First, is there anything around the patient that could injure them, such as sharp objects? If there is, remove the threat from the scene or move the patient to a safer area.

If the patient is having a zootomic clonic seizure – in which they are fluctuating between contracting and relaxing – they could bang their head on the ground. To protect their head, simply cup your hands together and place them underneath the patient's head.

Warning: Never hold down a seizing patient or try to stop the seizure in any way. Just support and protect the patient during the seizure. Then, once the seizure is over, assess for more serious situations like cardiac arrest.

How to Treat a Patient after a Seizure

Pro Tip #1: There are several things to do post-seizure, but the most important is calling 911 and activating EMS if it hasn't already been done. As soon as you determined that the patient had a seizure, and you don't know if the patient is an ongoing epileptic, call 911 immediately.

After EMS has been activated, begin to assess the patient for a couple of things.

Is the patient moving and breathing normally again?

Are they beginning to return to consciousness?

If the patient isn't moving or breathing normally, and isn't responsive to your taps and shouts, go right into CPR and retrieve or find an AED.

If the patient is beginning to breathe normally again, does the breathing appear to be agonal respirations or more corrective breathing? To help keep the patient's airway open and clear, put them into the following recovery position.

  • Elevate the arm closest to you and bring it up over the patient's head before placing it on the ground.
  • Bring the patient's furthest leg over their other leg so that their legs are crossed.
  • Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the patient toward you and onto their side.
  • Support the head while you place the patient's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway.
  • Bend the patient's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the patient from rolling over.

Pro Tip #2: A person who has just experienced a seizure – essentially an electrical storm in the brain – will be low on oxygen. As a result, they may be confused or combative and this will likely last a few minutes.

While waiting for EMS to arrive, continue to assess the patient for breathing and recovery signs, like talking. Any signs that the patient is becoming more responsive are good signs.

If the patient begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive.

A Word About Pediatric Seizures

A seizure is a disorder in the brain's electrical system, which is sometimes marked by loss of consciousness and often by uncontrollable muscle movement, also referred to as convulsions.

In children, febrile seizures are the most common type of seizure. These seizures occur with a rapidly-rising or excessively-high fever, typically higher than 102° F. Children with febrile seizures may exhibit some or all of the following signs and symptoms:

  • Sudden rise in body temperature
  • Jerking of the head and limbs
  • Loss of bladder or bowel control
  • Confusion
  • Drowsiness
  • Crying out
  • Becoming rigid
  • Holding the breath
  • Rolling the eyes upward

To assess what type of seizure the child has had and why, it's important to ask good questions:

  • Has the child ever had seizures before? If so, is the child on medications for them? If not, is there a family history of seizures?
  • Does the child have diabetes? If so, what type of insulin/medication is being used and when was the last time it was given?
  • Has the child started taking any new medications lately? If the child takes medications, is it possible there may have been an overdose? Could the child have taken someone else's medication by accident?
  • Could the child have ingested anything poisonous?
  • Has the child had a recent injury, particularly a head trauma?
  • Has the child seemed sick or had a high fever, stiff neck, or headaches?
  • What did the seizure look like? Did it involve the child's whole body, or only one half of the body?
  • Did it start in one area and progress to the rest?
  • Did the child fall when the seizure began and if so, was it possible the child's head struck an object or the floor?

These are just some of the questions you can use to help decipher what type of seizure the child had and why.