Seizures

Question 1

Definitions

Answer 1

a seizure is the result of abnormal, spontaneous an uncontrolled electrical discharge from a group of neurons in the brain

Question 2

Goal of Care

Answer 2

Prevent aspiration and secondary injury, transport to hospital

Question 3

Seizures

Answer 3

Most commonly occur in early childhood or late adulthood

Seizure activity is not a disease but a symptom of an underlying CNS dysfunction.

an ongoing seizure disorder may occur secondary to head trauma, brain surgery or long term drug or alcohol abuse

Question 4

Cues

Answer 4

Loss of awareness

Twitching or shaking of body, associated w/ uncontrolled muscular contractions

Question 5

Guiding principles

Answer 5

Beware that a sudden loss of BP in cardiac arrest can result in seizure activity. A pulse check should be done immediately on arrival at a seizure call if the pt is not awake

**Beware of injs. Sudden LOC can cause serious inj from falls and accidents. Intense rapid muscle contraction can cause inj to soft tissue and even dislocated joints or rarely, broken bones

Status epilepticus is defined as an ongoing seizure >5mins or recurrent seizures w/o full neurological recovery in the interim

Diagnosis of “febrile seizure” should not be made in the field

Question 6

Causes

Answer 6

• Hypoxia
• Hypoglycemia
• Withdrawal of alcohol or benzodiazepines
• Acute head inj
• Exposure to toxic drugs
• Structural damage to the brain
• Hyponatremia
• Meningitis or encephalitis
• Fluid accumulation in the brain
• Epilepsy
• Febrile Seizures

Question 7

Intervention Guidelines

Answer 7

EMR
Position pt
If still seizing protect pt from potential inj
Supplemental O2
Correct suspected or confirmed hypoglycaemia
Glucogel 1 package

PCP
correct hypoglycaemia
- Glucagon 1mg IM
- Dextrose 10-25g D10W IV

ACP
Midazolam 5-10mg IM
2-5mg IV increentally to effect