Person who has a seizure

mydesygn · Nov 28, 2005

I'm curious as to how you would answer this. I was in disagreement with The Red Cross when they taught this. I really had no business taking a CPR course from them since I was a nurse and my reactions would be different....but consider this scenerio and tell me what you would do....
You're walking through the mall. Everyone's rushing around you trying to get their Holiday shopping done and you hear someone calling for help. In the middle of the floor is a 54 year old man who is having what appears to be a grand mal seizure. What first aid would you render? After rendering this first aid, would you call 9-1-1? Why or why not?

First, Protect the indiviual from danger (ie remove any objects that may be near) but do not restrain the indiviual or try to put any type of bite block. Bite blocks generally result in broken teeth and possible aspiration that's far worse than the remote possibilty they might bite their tongue.

Second, monitor and allow the seizure to complete, do not interfere rarely does any seizure result in respiratory arrest. When the seizure passes, the indivual will resume a normal breathing pattern.

Third, if there is no family, notify 911. Often the family are aware of the seizure type and frequency, they will usually determine if the indiviual needs to be seen in an ER.

DD-RN · Nov 28, 2005

My son has had more than 500 grand mal seizures, so my advice is based on my experience with his seizures only. When turning the patient on his side, turn to the side that he is seizing towards to allow the saliva to flow out. Protect head with a jacket or your hands. Don't restrain or place anything in the mouth. Time the seizure.

Have someone else call 911 even if the seizure stops after 3 minutes. You never know when a second one could start and that would be a sign of status epilepticus. My son is prone to those and I would want someone to call 911 if he seized at the mall. Like others have said, the person can always decline going to the E.R., but it would be best to get checked out by paramedics.

Also check for a medic alert necklace or bracelet and call the family member that they might have listed on it.

vampiregirl, BSN, RN · Nov 28, 2005

I agree that calling 911 asap is the best route to go. While I am still a nursing student, and don't yet understand all the nursing thinking processes, I have been in EMS for over 8 years. You really don't have anyway of knowing if the person is going to come out of the seizure or go into another seizure, especially if no one is around with the seizing individuals history. With a sustained seizure, the affects of hypoxia can be significant and need to be quickly addressed for the best possible outcome. Also, a person having a seizure needs to be coherant before they can be accurately assessed for injuries (for example, injuries sustained in the process of getting to the ground), and sometimes the post-ictal state can go for a while. Any compentent EMS personnel would be glad to respond to an individual who had a seizure, assess them, and sign them off if medically appropriate.

Agnus · Nov 28, 2005

Protect them from injury.

Turn on side if possible.

Call 911.

time seizure

This is a stranger. Always call 911 in this case have someone else call and Make sure they did it.

If the vicitim refuses to go with the amblulance crew that is not your problem. They can refuse after the ambulance arrives that is thier right.

If the family is present and says do not call then I might step away from the situation.

Frankly I am reluctant to get involved when starngers are involved anyway.Unless someone I am with has the naivity to identify me as a nurse.

In most states there is no law that says you must get involved.

It is NOT within my scope as a bystander (even RN) to make a judgement that a stranger does not need further medical evaluation.

Call 911. You can not go wrong erring on the side of safty.

They have the right to refuse to go in the ambulance but at least you did your part and made it possible. If you with hold calling you have in effect with held further medical help. I don't have the legal right to make that decision for someone else.

You can not be held lible (sp?) for callin 911 you can be if you get involved and tell someone not to call or fail to call.

Arizona Mark · Nov 28, 2005

I'm curious as to what the original poster's instructions were to do from the Red Cross........

Several responders insist on calling 911 no matter what. But, in fact there are individuals who live with seizures every day of their lives. If your victim comes out of it after a minute and states he is fine and this occurs all the time, are you still going to call. If there is a friend, associate with the victim that basically relays the same info. to you , are you still going to call. Remember, your call to an ambulance may be taking that EMT away from another emergency..........

I'm not passing judgement, but perhaps some of you are not using sound, reasonalbe decision making simply in order to CYA ?

Just a thought .................. :saint:

allnurses Guide · Nov 28, 2005

I'm curious as to what the original poster's instructions were to do from the Red Cross........
Several responders insist on calling 911 no matter what. But, in fact there are individuals who live with seizures every day of their lives. If your victim comes out of it after a minute and states he is fine and this occurs all the time, are you still going to call. If there is a friend, associate with the victim that basically relays the same info. to you , are you still going to call. Remember, your call to an ambulance may be taking that EMT away from another emergency..........
I'm not passing judgement, but perhaps some of you are not using sound, reasonalbe decision making simply in order to CYA ?
Just a thought ..................

I think the example was in a busy mall and you don't know the person or their history. And there was no mention of family or friends nearby. If the person comes right out of it and refuses an ambulance, of course you cannot do anything against their will.

However, other things can mimic seizures and some seizures are life-threatening.

I have seizures. Call 911.

steph

boulergirl, CNA · Nov 28, 2005

As a caregiver I was taught to leave a person in grand mal seizure alone until they stop seizing, then assess the person for breathing and pulse, and render aid as necessary. As far as ANY emergency goes, the guy who taught the class emphasized that we "PHONE FIRST, PHONE FAST!" That motto was drilled into our heads over and over.

Another thing: If the person seizing is hitting their head on a hard floor, we were told that it's okay to stick a pillow under it.

grannynurse FNP student · Nov 28, 2005

As a caregiver I was taught to leave a person in grand mal seizure alone until they stop seizing, then assess the person for breathing and pulse, and render aid as necessary. As far as ANY emergency goes, the guy who taught the class emphasized that we "PHONE FIRST, PHONE FAST!" That motto was drilled into our heads over and over.
Another thing: If the person seizing is hitting their head on a hard floor, we were told that it's okay to stick a pillow under it.

I suffer a seizure disorder and take medication. Should I suffer one, in public, I hope someone has the good sense to call 911. If I do not want their help, I will let them know after they arrive.

Grannynurse:balloons:

allnurses Guide · Nov 28, 2005

I suffer a seizure disorder and take medication. Should I suffer one, in public, I hope someone has the good sense to call 911. If I do not want their help, I will let them know after they arrive.
Grannynurse:balloons:

Woot! We agree on something . . and we share a disorder. :)

steph

boulergirl, CNA · Nov 28, 2005

I suffer a seizure disorder and take medication. Should I suffer one, in public, I hope someone has the good sense to call 911. If I do not want their help, I will let them know after they arrive.

The guy who taught our CPR/First Aid class told us repeatedly "PHONE FIRST, PHONE FAST" while holding up his cell phone for everyone to see. I was told to call 911 and get the ambulance enroute before doing anything else in an emergency situation. I'll never forget seeing the instructor whip out his cell phone over and over again as a visual aid. :chuckle

MIA-RN1, RN · Nov 28, 2005

I learned something years ago from a neurologist and I have never met anyone that was familiar with this. I have had need to use it rarely, but it has worked for me the few times I have used it.
If the person is also not breathing and turning blue, pinch their nostrils together. It signals the brain to breathe and it works. They gasp for air about 10 seconds after you do it.

My son used to have seizures and the pediatrician told me to give two rescue breaths to break the seizure. Doc actually did this when son seized in the office one day.

Arizona Mark · Nov 29, 2005

Given the totality of the responses favoring calling 911, I am going to modify any future responses on my part. If I am in such a situation, I would now likely call 911 if I am dealing with a stranger.

The people I based my earlier information on are known individuals, and the company policy is , as stated earlier, don't call if less than 3 minutes. However, in a stranger situation, yes, it makes sense to err on the side of caution.

Thanks to all who have set me straight, I appreciate it