As a paramedic student, I have learned a lot about how to care for a person in seizure. I have learned an extensive amount about the body systems involved with respects to seizures, but most importantly, I now know how to assist these individuals.
Firstly, it is important to remain calm and understand that you are able to help someone that is having a seizure. Allow the seizure to run its course, while running through the following steps to assist them as best as you can.
To begin, it is crucial to identify the cause of the seizure. Ask any bystanders if they have useful information to help tell you why the patient may be presenting the way they are. If there are no bystanders, it is helpful to look for some medical alert bracelets or necklaces. The list below provides some valuable reasons to why a person may be having a seizure:
1. Epilepsy/Seizure disorder
2. Alcohol/ Drugs
4. Insulin (Too high/Hyperglycemia or Too low/Hypoglycemia)
Even if the cause has not been determined, it is important to start caring for the seizing patient. According to the Basic Life Support Patient Care Standards which is followed by Ontario paramedics, for a patient in active seizure, the next step is to place them in the recovery position. This is when the patient is placed on their side, which allows fluids to flow out of their mouth due to gravity. If the patient is seizing due to a stroke, they must be placed on their paralyzed side. However, this may not always be possible if the patient has stiff muscles; in which case, it is best to leave them in the position they are found as long as they are safe.
At this point, you should time the seizure. This is because seizures that repeat or last longer than five minutes or are considered a medical emergency due to the possibility of apnea. Apnea means that the patient will stop breathing. Therefore, rapid transport as a paramedic is crucial in this case.
Once these steps are completed, it is ideal to move any objects that could be hazardous to them. This means, moving anything that they can grab easily and moving any items near the head. Ensure that you do not put anything in their mouth as this puts the patient at risk of chocking. This step should be done quickly, and will give you better access to the patient while making sure they are safe.
Now that you have completed all of the steps above, it is time to check their breathing. If you hear grunting, moaning or feel any air exiting the person’s nose or mouth, that is a great sign. This means that they are still breathing on their own. You can also look for the colour of the patients face. If they appear pink, or of normal colour, they are breathing adequately; however, if they appear blue, this means that they are lacking oxygen and their breathing has decreased significantly. Be sure to constantly check their breathing to see if it has changed during the course of the seizure.
If the patient comes out of their seizure while you are with them, reorient them and tell them what has happened. If they are aggressive, try to calm them down and call the police if required. Evidently, some individuals may require additional care depending on the cause of their seizure and the situation; however, any help can aid the seizing patient.
I hope you learned something new today. Until next week!
*Please note that these are some helpful tips and advice on how to care for a patient that is in seizure; however, this is not how all paramedics will respond to a seizing patient nor is it direct protocol. For more information on how Ontario paramedics treat seizures, please see page 82 labelled Seizure Standard of the following document:
You can also see Epilepsy Durham Region’s First Response Protocol.