Seizure while eating- what to do?

[ajangel25]

Hi everyone! I work in a home for young patients with severe developmental disabilities. Most are tube fed, but a few eat and all of them have epilepsy. Anyway, the other night one that eats PO had a seizure during dinner time. Luckily she didn't choke but it got me thinking- what would I do if she did started choking while seizing? Is it possible and safe to perform the heimlich on a patient during a seizure?

[MurrR]

I guess what I'm imagining is that they're probably falling/sliding out of their chair during the seizure - unless it's not that kind of seizure - and once they're on the floor, having them in the usual on-their-side position so that any vomit or sputum drains out of their mouth would probably prevent any choking. But if you don't have a protocol for choking that includes instructions on choking while seizing, it might be time to call your supervisor and ask if the nurse can add one!!

[PerfectlyPlump, ADN, RN]

Hello,

What a bad coincidence! Where I worked in DD, the policy would definitely include calling 911 due to the seizure alone, while getting the pt. onto the floor and onto his side, as MurrR said. Then if he started to show signs of choking, I would think of getting behind him and starting heimlichs. Soon the seizure would stop (we hope), and you can continue to deal with the choking. If the paramedics come and all is resolved, be happy! Otherwise they could take over in the choking situation, and you could go get your Dilantin if the seizure is still present.

[MurrR]

Hello,

What a bad coincidence! Where I worked in DD, the policy would definitely include calling 911 due to the seizure alone, while getting the pt. onto the floor and onto his side, as MurrR said. Then if he started to show signs of choking, I would think of getting behind him and starting heimlichs. Soon the seizure would stop (we hope), and you can continue to deal with the choking. If the paramedics come and all is resolved, be happy! Otherwise they could take over in the choking situation, and you could go get your Dilantin if the seizure is still present.

Where I would work, we don't always call 911 for seizures. Some of our clients have seizure disorders and one sneaks through the meds, so to speak. But we have a protocol that lists when to call 911. Like, more than X # of seizures in X amount of time, or if they've never had a seizure before, or if this or if that. If I had called 911 every time one of my clients had a seizure where I worked last fall, we would've had them at the house 24/7 between the five guys we had there.

So, yeah, if your seizure protocol doesn't include information like that - it should!

[tainted1972, ASN, RN]

If you think about the the ABC's. Airway is top priority, I agree that safety is important; but what good is it going to do if the client cannot breathe?

I would have someone call 911 (which should always be done when someone chokes) and then I would do whatever I could to clear the airway, then deal with the seizure.

Some people disagree with calling 911 for choking, my opinion is that if a person is choking there is no guarantee that you will be able to dislodge the object and clear the airway.

In my facility we have a 5 minute rule for seizures.. we call 911 for anyone having a seizure longer than 5 minutes regardless of their seizure history. For residents who have no seizure history or rarely have seizures we call 911 right away.

[PerfectlyPlump, ADN, RN]

I so agree that there needs to be a more specific protocol. Lots of times the activity was over before we could call. Totally uncomplicated, thankfully.

[willgr]

In case a seizure while eating takes place and the victim eventually chokes on his food, is he feeling pain or is it an unconscious death?