Seizures - Neurological Emergencies

Question 1

Primary Survey

Answer 1

• Confirm there are no D-Spine precautions
• Assess lvl of consciousness (AVPU scale)
• Assess and manage ABC’s as required
• Complete RBS - visualize, palpate, where appropriate
• Intervene at each injury site per traumatic injuries list
• Apply O2 (standard face mask or non-rebreather)
• Consider the position based on findings and comfort

Question 2

Decision Point

Answer 2

Patients with a decreased LOC or ongoing seizures are unstable

Question 3

Load and Transport

Answer 3

Transport the unstable patient immediately after the primary survey

Question 4

Critical History

Answer 4

• The nature of the seizure (generalized or focal)
• The duration of the seizure
• Any preceding symptoms (eg. presence of an aura)
• Any trauma during the seizure from falling or collision with objects
• Any complaints of recent illness or injury
• Note the use of anti-convulsant medication
• Note recent compliance or any change in medication
• Note the past history of seizures
• Note any history of hypertension, head injury, CVA, fever, drug and alcohol abuse, diabetes or other disorders

Question 5

Patient History

Answer 5

SAMPLE/OPQRRRST

Question 6

Vital Signs

Answer 6

• Complete enroute to hospital in unstable patient
• Assess blood glucose lvls
• Assess pupil size & reactivity
• Complete vital signs q5 for unstable PT
• Complete vital signs q15 for stable patient

Question 7

Hospital Notification and Head to Toe/Functional Inquiry

Answer 7

Complete enroute to hospital

Question 8

Protocol(s)

Answer 8

Diabetic protocol (if indicated)

Question 9

Treatments

Answer 9

• Monitor PT’s airway
• Ready portable suction machine in anticipation of airway complications
• Do NOT put fingers in PT’s mouth or attempt to insert OPA while seizure is in progress
• Be aware that bright flashing lights, loud noises, or rough handling may trigger subsequent seizures