Big Brother - Hypoglycemia Seizure

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If someone is having a seizure as a result of hypoglycemia, wouldn't giving them something by mouth be a risk for aspiration? I'm asking this because I was watching Big Brother the other night and on of the contestants had a seizure and then the nurse was putting something in her mouth, is this what you normally do? I'm currently in nursing school and we just studied diabetes and hypo and hyperglycemia but we didn't really touch on what you would do if they were having a seizure.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

If you give someone something PO during a seizure you will be at very high risk of aspiration! Lets delve into this and see why...

When you are having a grand mal seizure, it not only makes all your muscles twitch, but your diaphram too...typically you are not breathing if breathing well during it. So what happens when you come too? Well...hopefully someone is there to protect your airway and allow that first huge breath to come in! Think about having something in the mouth at this time...you are going to gasp hard for air and lodge whatever is in your mouth and block the airway!

Typically (as I have been trained) you wait till seizure end and make a choice to get an IV in and get that dextrose going (per MD order of course or unless you have protocols for this administration), or assure you have a stable airway and consciousness then give an appropriate sugar replacement (I prefer the chewable kind of tabs or gels vs drink...drinks can be aspirated too easily if there is any probelms with potentially comprimized airways) or go the ol PR way (thankfully I have never had to do this!).

Thank goodness we don't go to watch Big Brother for medical training huh? Too bad patients seem to watch shows like this and make their couch dx's with us huh?

Also, since I didn't watch this and never will...LOL, I wonder if she was going old fashioned and went to put something in her mouth to save her tongue or teeth. This is contraindicated now...but for a long time people placed some type of tooth guard item in their mouths.

It seems common sense to me that the first priority is maintain airway during and post seizure THEN fix the underlying probelm once stable. ABC's work well...

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Another thing that may scare me about this practice, if something sugar related was given...was a CBG taken? Proably not! Then how did that nurse know it was hypo vs hyper???? I have seen the tragic results of common folks automatically assuming a change in a diabetics behavior or seizure is for HYPO...and gave them lots of sugar only to find out they were hyper!!! I have seen folks die from this action!

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Specializes in Developmental Disabilities, LTC.

Aaaah - another example of why we were always taught that Assessment is always the 1st & more important step in the nursing process.

Can't do anything until you assess!

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Specializes in OB, M/S, HH, Medical Imaging RN.

at the time that the nurse was putting glucose gel inside the cheek of amanda's mouth, she was not seizing yet, but i don't think the gel would necessarily cause aspiration, that is the purpose of it being a gel rather than a liquid. also since there was no iv access what else could she have done immediately? the nurse knew it was hypoglycemia because amanda just got through saying she had not been eating and was in desperate need for a little sugar but wouldn't eat a cookie since going by the rules of the show she wasn't allowed to.

if you watched the show you know that literally a minute before amanda passed out, allison was having a severe if not anaphlactic reaction to something and the nurse was injecting her with epinephrine.

lightening struck twice in the same spot at literally the same time. it was really freaky.

thank goodness we don't go to watch big brother for medical training huh? too bad patients seem to watch shows like this and make their couch dx's with us huh?

also, since i didn't watch this and never will...lol, i wonder if she was going old fashioned and went to put something in her mouth to save her tongue or teeth. this is contraindicated now...but for a long time people placed some type of tooth guard item in their mouths.

it seems common sense to me that the first priority is maintain airway during and post seizure then fix the underlying probelm once stable. abc's work well...

what would you do if you're at home and one person has a severe reaction, lips swollen twice their usual size, arms swollen, gasping for breath...you just happen to have epi at hand and at the same time another person who you know is hypoglycemic and hasn't eaten goes down? i thought this nurse did a great job considering the circumstances.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

Thanks for the explanation! I don't get a chance to watch TV anymore...and even when I get free time, my hubby has total rule over the TV remote..LOL! I typically read or sleep...LOL!

Yep, gel is the way to go because it is easily absorbed and lower risk of aspiration! It is a murphy's law for me most of the time...when I need it it isn't there, or the pixis has it...uhggggg! Lucky for me however, most of my patients do have IV access...whew!

Oh man...an anaphalaxis and seizure at the same time basically...sounds like "one of those days in the life of a nurse" huh. Need to be in more than one place doing more than one thing all at the same time...

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yep, i've given choc syrup, sugar w/gtts of h2o (to make a paste) to those seizing r/t hypoglycemia.

it will be absorbed intrabuccally.

but as triage says, as long as you know, w/o a doubt, that the sugar is low.

leslie

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Specializes in Education, Acute, Med/Surg, Tele, etc.

"what would you do if you're at home and one person has a severe reaction, lips swollen twice their usual size, arms swollen, gasping for breath...you just happen to have epi at hand and at the same time another person who you know is hypoglycemic and hasn't eaten goes down? i thought this nurse did a great job considering the circumstances."

considering i didn't see the show, which i did mention, i did not know about the other probelm...i was commenting on what the op had asked.

with your description...the nurse seemed to have done an awesome job!

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Specializes in OB, M/S, HH, Medical Imaging RN.
yep, i've given choc syrup, sugar w/gtts of h2o (to make a paste) to those seizing r/t hypoglycemia.

it will be absorbed intrabuccally.

but as triage says, as long as you know, w/o a doubt, that the sugar is low.

leslie

yep, i agree, only if you know "for sure". i have made a paste as well and yes it worked well. sugar and cream.

i have always watched "big brother" and in 9 years they've never had any medical issues that i knew of. apparently there's a medical room of sorts for emergencies. allison had just gone into that room and you could hear her saying "i need epi, i'm reacting"...while gasping, when the next thing you see is amanda going down just in front of the door. she was obviously headed there while saying "i need sugar, i just need some sugar". i have never even noticed that door before (i'm sure that's on purpose).

in contrast to "survivor", there have been some medical emergencies. they have more or less a small mobile er. of course they are 100's of miles from civilization and more likely to have emergencies being out in the wild somewhere, etc....one particular contestant suffered 3rd degree burns and once stabilized was lifted out by helicopter. just interesting to me. i like reality tv. i'll admit it!

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Specializes in Cardiothoracic Transplant Telemetry.

They said on the show that they were going into the diary room. Whenever they have a issue of any kind they will go in there and ask for help, whether it is to talk to a producer, tape a diary entry, speak to the staff psychologist, or to seek medical attention.

As for the whole Amanda thing, I know that it sounds horribly cynical, but I suspect that she may have let her sugar go that low on purpose to regain the good will of the house. People who have histories of serious hypoglycemic reactions know the signs, and she was saying that her sugar was low, and that she wasn't feeling well, while refusing to eat, and making sure that someone was with her. She could have eaten some big brother "slop" with sugar on it, and this was suggested to her before she went down, but she refused. I don't think that she meant to have a seizure, but I can see her thinking that if she passed out that she would get attention and that everyone would feel sorry for her and not vote her out.

I know that I am a suspicious person, but we will all have to see what happens tonight on the show. I noticed that someone made her a peanut butter sandwich when she got back, so does that mean that she doesn't have to eat the slop now?

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I just started a paramedic program, so we havent learned our pharmacology yet, but ive heard several stories of administering drugs rectally during a seizure, i didnt see anyone mention this? is this something only used in the field?

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Thanks for the replies. I agree she did a great job. I just wanted someone to clarify how the situation would be handled because I didn't know... I wasn't attacking her practice in any way.

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