Seizures Flashcards
Clinical Severity Prompts (4)
Rhythmical involuntary jerking (tonic-clonic)
Stiffening of the body
Clenched jaw
Altered level of consciousness
History Prompts (6)
Events - mechanism of injury
Associated symptoms
- altered level of consciousness, pale, sweaty, incontinence
Relevant past history
Medication history
Allergies
Onset
Position
Protect from further harm
Do NOT restrain the patient
Lie supine or left lateral (after tonic phase and clonic movements cease)
Airway - Assessment
Assess patency
Airway - Intervention
Maintain airway patency (a nasopharangeal airway is the recommended adjunct unless contra-indicated)
Stabilise the C-spine with in-line immobilisation and apply a semi-rigid cervical collar (if there is a possibility of injury)
Breathing - Assessment
Respiratory rate and effort
SpO2
(Auscultation)
Breathing - Intervention
Assist ventilation if required
Apply O2 to maintain SpO2 greater than 95%
Stop the seizures
IV Midazolam 2.5mg increments slow injection every 1-2 minutes (to a total dose of 0.1mg/kg)
if IV access not available,
IM Midazolam 10mg and repeat (once only) after 5 minutes if required.
Circulation - Assessment
Skin temperature (touch)
Pulse - rate & rhythm
Capillary refill
Blood pressure
Cardiac monitor
Circulation - Intervention
IV cannulation / pathology
Monitor vital signs frequently
Disability - Assessment
AVPU / GCS + pupils
BGL
Disability - Intervention
Monitor LOC frequently
If BGL < 3mmol/L administer IV 50% Glucose 50ml
or (if IV access unavailable)
IM Glucagon 1mg
Monitor finger prick BGL every 15 minutes until within normal limits
Measure & test
Pathology → Collect blood for FBC, UEC
Temperature
U/A
Fluid intake / output → FBC & Nil by mouth
Specific treatment?
Possible alcohol abuse.
If history of alcohol abuse, give IM Thiamine 100mg
