SHOCK,FAINTING AND

EPILEPSY
SHOCK
Introduction
• It is a condition caused by sudden collapse of circulation and a
dramatic drop in blood pressure.

• This result in inadequate supply of blood to the brain leading

suppression of vital functions of blood supply
Types
• Mild Shock: it is caused as a result of loss of 10-20% of blood volume
and easily treatable
• Severe Shock: Is produced as a result of loss of 30% or more loss in
blood volume.
• Anaphylactic shock: It is an extreme, often life-threatening allergic
reaction to an antigen to which the body has become hypersensitive.
It is treated urgently because delay will result in failure to respond
adequately. Eg, In cases of intravascular coagulation
• Traumatic shock (iligaemic or hypovolaemic shock): Result from
blood plasma loss. The causes are due to oligaemia or hypovolaemia
• Neurologic Shock: Caused by strong emotional upset often brought
about by fear, severe pain or bad news
• Cardiac shock: It is due to heart failure
• Toxic shock : It results from sepsis
• Spinal shock: It results from damage to spinal cord at the cervical or
upper thoracic level.
• Endocrine shock: It results from certain endocrine imbalances. Eg
Addison disease.
Causes
• Crush injuries
• Accidents
• Bacteria infection
• Severe burns
• Heart attack
• Dehydration
Signs and symptoms of shock
• Cold and clammy skin
• Cyanosis
• Pallor
• Weak and rapid pulse
• Sighing and irregular breathing
• Sweating
• Dilated pupil
• Thirst
• Loss of consciousness
• Restlessness
• Anxiety
• Confusion
• Dizziness and fainting
• Blurred vision
First Aid mgt.
• Reassure patient
• Make patient lie down in a head low position.
• Loosen tight clothing
• Do not allow crowding
• Look for any serious bleeding and control or arrest it.
• Cover with blankets to keep patient warm
• Do not give casualty anything to drink
• Moisten dry mouth with a wet flannel or towel
• Check vital signs frequently to assess level of shock
• Transport to the nearest health facility for medical care
Anaphylactic Shock
• anaphylactic shock is an extreme, often life-threatening allergic
reaction to an antigen to which the body has become hypersensitive.
• It can occur a short time after contact to trigger.
• Triggers include ;
-food (Eg. Peanut, fish, sesame oil, shellfish, diary product,)
- drug (Eg. penicillin)
- insect sting ( wasp or bee sting)
Signs and symptoms
• Intensely itchy rash
• Sudden drop in Blood pressure
• Anxiety
• Nausea and vomiting
• Abdominal pain
• Loss of consciousness
• Swollen face
• Rapid pulse
• Puffy eyes
• Difficulty in swallowing or eating
• Wheezing and breathing difficulty
First Aid Management
• Reassure patient
• Make patient comfortable
• If patient with history of anaphylaxis carry adrenaline. Only health
professionals are to give adrenaline.
• Administer asthma reliever inhaler to help relieve wheezing.
• Transport to the nearest health facility for further management.
FAINTING (SYNCOPE)

• Fainting or syncope is a state of temporary unconsciousness due

to diminished blood supply to the brain (cerebral anaemia)
Causes
• Exhaustion
• Lack of food, or exertion while in a state of fatigue
• Emotion
• Fright, mental shock or fear
• Accident which involve blood loss
• Poor ventilation
• Posture. Sudden upright stand after resting
Signs and symptoms
• Dizziness
• Pallor
• Cold and clammy skin
• Weak and rapid pulse
• Temporal loss of consciousness
First Aid management
• Reassure patient
• Put patient lying down with head and shoulder low with the feet
raised and supported in an elevated position
• Avoid crowding to allow proper ventilation
• Provide warmth by covering with a blanket
• Give hot sips of hot tea or coffee on return to consciousness
EPILEPSY
Epilepsy
• It is the sudden disruption of electrical distribution in the brain.
Types of Epilepsy
• Partial Seizures:
• It leads to focused seizures based on the part of brain affected.
• It is also called Petit Mal seizure.
• The person suddenly forget his present and go into a state of
daydreaming briefly.
• Examples include; a strange feeling like a ‘wave’ going through the
head, getting an unusual smell or taste, a sudden intense feeling of
fear or joy.
Generalized seizure
• It is also known as grand mal
• Generalised seizures affect both sides of the brain at once and can
happen without warning.
• The person will be unconscious even if just for a few seconds.
• Afterwards they will not remember what happened during the
seizure.
Causes
• Hereditary
• Brain damage caused by head injury, tumours, brain suffocation or
difficulty at birth.
• Certain diseases such as diabetes mellitus, liver failure.
• Certain poisons such as pesticides
• Large intake of alcohol
• High temperature in children
• Unknown cause
Trigger Factors

• Stress
• Illness (both with and without fever)
• Heavy alcohol use or seizures after alcohol withdrawal
• Nutritional deficiencies: vitamins and minerals
• Climbing higher heights
• Flashing lights or patterns
• Specific activities, noises or foods
• The menstrual cycle or hormonal changes
• Missed medication
• Use of cocaine and other recreational drugs such as Ecstasy
• Over-the-counter drugs, prescription medications or supplements
that decrease the effectiveness of seizure medicines
• Poor eating habits, such as long times without eating, dehydration or
not enough fluids
Characteristics of Seizures
Absence seizure
• During an absence a person becomes unconscious for a short
time(10-150secs).
• They may look blank and stare, or their eyelids might flutter. They will
not respond to what is happening around them.
• If they are walking they may carry on walking but will not be aware of
what they are doing.
• After seizure, they may continue with their activity and have no
memory of what had happened.
Tonic-clonic or grand mal
The person may be unconscious for up to 10 minutes and become sleepy for 1
to 2 hours after seizure
Before Seizure
• There is a change in mood or behaviour several hours or days before seizure.
This is called wasprovoke
• Immediately before seizure, the person feels an imaginary smell or vision.
This is known as aura phase
• Then become unconscious followed by stiffening of the leg and arms. This
stage is known as the tonic phase
• This is then followed by jerky movement of the limbs and face. This is called
the clonic phase
There may be loss of bladder control and patient may bite tongue

After the seizure (once the jerking stops):

• their breathing and colour return to normal
• they may feel tired, confused, have a headache or want to sleep.
First Aid Mgt.
• Ease the person to the floor.
• Turn the person gently onto one side. This will help the person
breathe.
• Clear the area around the person of anything hard or sharp. This can
prevent injury.
• Put something soft and flat, like a folded jacket, under his or her head.
• Remove eyeglasses.
• Loosen ties or anything around the neck that may make it hard to
breathe.
• Stay with the person until the seizure ends and he or she is fully
awake.
• After it ends, help the person sit in a safe place.
• Once they are alert and able to communicate, tell them what
happened in very simple terms.
• Comfort the person and speak calmly.
• Check to see if the person is wearing or a medical bracelet or other
emergency information.
• Keep yourself and other people calm.
• Do not hold the person down or try to stop his or her movements.
• Do not put anything in the person's mouth. This can injure teeth or
the jaw. A person having a seizure cannot swallow his or her tongue.
• Do not try to give mouth-to-mouth breaths (like CPR). People usually
start breathing again on their own after a seizure.
• Do not offer the person water or food until he or she is fully alert.
Complications
• Wounds
• Fractures
• Status Epilepticus
• Epileptic psychosis
• Coma