SEIZURES

Pavlo Razumnyi, MD, International SOS Physician

 A seizure — also
called a convulsion
 Seizures

A seizure consists of involuntary
contractions of many of the
muscles in the body

 The condition is due to a

disturbance in the electrical activity
of the brain
 Seizures usually result in loss or
impairment of consciousness
 Seizures
 The most common cause is
epilepsy

 Other causes include

• head injury
• some brain-damaging diseases
• shortage of oxygen or glucose in
the brain,
• the intake of certain poisons,
including alcohol or drugs
Seizures

 Tonic-clonic seizures are

also called generalized motor
seizures or grand mal seizures
Seizures
Seizures
 During the tonic phase
of a seizure, the body’s
muscles stiffen

 During the clonic

phase, alternating
jerking and relaxation
of the body occur
Seizures

 A tonic-clonic seizure
usually has 4 phases
 Seizures - Phases
 Aura. The aura serves as a warning that a
seizure is going to begin and involves some
type of sensory perception by the patient

 The aura may be a sound, an abnormal

twitch, anxiety, dizziness, a smell or odor, an
unpleasant feeling in the stomach, visual
disturbance, or odd taste

 Many patients will tell you that they knew

they were going to seize because of the aura

 However, generalized seizures do commonly

occur without the preceding aura
Seizures - Phases
 The aura is followed by a loss of
consciousness

 During the tonic phase, the body’s

muscles stiffen

 The patient’s breathing may be

noisy, and he may turn blue

 This phase usually lasts 15 to 20

seconds
 Seizures - Phases
 During the clonic phase,
alternating jerking and
relaxation of the body
occur

 The jerking movements

during the clonic phase
are often called
convulsions

 This is the longest phase

of the seizure
Seizures - Phases
 The postictal phase is the period
of recovery that follows a seizure

 During this period, the patient

often appears limp, has shallow
breathing, and has an altered
mental status

 The altered mental status may

appear as confusion, sleepiness,
memory loss, unresponsiveness, or
difficulty talking
Seizures - Phases
 During postictal phase the
patient slowly awakens

 He may complain of a
headache and muscle soreness

 The postictal phase generally

lasts from 10–30 minutes. It
could last much longer
Seizures – First Aid
Seizures – First Aid

 To protect the casualty from

injury during the seizure

 To care for the casualty when

consciousness is regained and
arrange removal to the hospital if
necessary
 Seizures

 10 First Aid steps
(when someone has a convulsive seizure)
 Stay calm
 Look around - is the person in a dangerous place?  If not, don't move them. Move
objects like furniture away from them
 Note the time the seizure starts
 Stay with them. If they don't collapse but seem blank or confused, gently guide them
away from any danger. Speak quietly and calmly
 Cushion their head with something soft if they have collapsed to the ground.
 Don't hold them down
 Don't put anything in their mouth
 Check the time again. If a convulsive (shaking) seizure doesn't stop after 5 minutes, call
for an ambulance
 After the seizure has stopped, put them into the recovery position and check that
their breathing is returning to normal.  Gently check their mouth to see that nothing is
blocking their airway such as food or false teeth. If their breathing sounds difficult after the
seizure has stopped, call for an ambulance
 Stay with them until they are fully recovered
Seizures – First Aid
 Make space around the casualty,
and ask bystanders to move
away

 Remove potentially dangerous

items, such as hot drinks and
sharp objects

 Note the time that the seizure

started
Seizures – First Aid
 Protect the casualty’s head from
objects nearby

 Place soft padding such as

rolled towels underneath or
around his neck if possible

 Loosen tight clothing around his

neck if necessary
Seizures – First Aid
 When the convulsive
movements have ceased,
open the casualty’s airway
and check breathing

 If he is breathing, place
him in the recovery
position
Seizures – First Aid
Recovery position
Seizures – First Aid

 Monitor and record his vital signs

— level of response, breathing,
and pulse — until he recovers

 Make a note of how long

the seizure lasted
Seizures – First Aid
 Protect the airway. A patient who has just
had a generalized seizure will sometimes
drool and will usually be very drowsy for a
little while, so you may need to suction
the airway

 If there is no possibility of spine injury,

position the patient on his side for
drainage from the mouth
Seizures – First Aid
 If the patient is cyanotic (blue), ensure an open
airway and provide artificial ventilations with
supplemental oxygen

 Patients who are breathing adequately may be

given oxygen by nasal cannula or nonrebreather
based on pulse oximetry readings

 Hypoxia is common after long periods of seizure

activity
Seizures – First Aid
 Treat any injuries the patient may have
sustained during the convulsions, or rule
out
trauma (ABCDE)

 Head injury can cause seizures, or the

patient may have injured himself during
the seizure

 Immobilize the neck and spine if trauma is

suspected
Seizures - Status epilepticus
 Status epilepticus is recurring seizures without an
intervening period of consciousness

 Status epilepticus is a medical emergency

 It can cause brain damage or death if it is not treated

 Complications associated with status epilepicus include the

following:
• Aspiration of vomitus and blood
• Long bone and spine fractures
• Dehydration
• Brain damage caused by a lack of oxygen or a depletion of
glucose (sugar)
 Seizures – First Aid

 If a convulsive (shaking) seizure doesn't stop after

5 minutes, call for an ambulance

 Transport to a medical facility, monitoring vital

signs and respirations closely
Seizures – First Aid
Seizures
Seizures
Thank You