Seizure Pts: what to do when it happens?

Specialties Med-Surg

Published

Hey guys. I recently had like 2 seizure precaution patients and I was wondering what necessary items should be by the bedside at all times and what to do if it happens.

What do you do it your present with the pt having a seizure?

and what do you do if a family member claims the pt had one but it was over when you got there?

I am so scared that i'll have a pt seizure and I won't know what to do.

thanks.

so I finally had an actual pt that had a seizure. Although i wasn't in the room, the doctor came to the nursing station stating that my pt just had a seizure and she bit her tongue and is bleeding.

what we did?

about 2-3 nurses helped me with the situation. We got suction set up, a handy airway, and ativan and eventually set her to ICU because doctors didn't like the way she was looking.

If i would have been in the room during her seizure, would I have just let her seize and wait till it was over?

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Specializes in Utilization Management.

No, you're not just "waiting." After you've alerted someone, if there is no standing order--you're gathering data for the neurologist. You're counting the seconds to how long the seizure lasts, noting what the patient was doing at the time of the seizure, the area of the body where the seizure began-- and more. On this website, scroll down to page 4 and read under General Guidelines, where it lists the things you need to note: http://www.ddsn.sc.gov/NR/rdonlyres/58BC1F39-F57F-496F-B58E-31A244BAC23B/0/NursingMgmtSeizures.pdf

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Specializes in PICU/Peds.

seizures are pretty simple. just ensure that there is oxygen and suction in the room. although they are rarely needed. just time and observe the seizure, ensuring the patient is safe, with enough padding around them so as not to injure themself. there isnt much to do. If they do not come out of their seizure within a couple minutes, then draw a whatever PRN med (usually ativan) is ordered for their seizures. dont bother trying to get vitals with a GTC because they are often hard to obtain and inaccurate. some will throw oxygen on a seizing patient, because they may desat a little but its usually not necessary.

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Specializes in private duty/home health, med/surg.

When you have a patient admitted with a seizure disorder, ask them a few questions. What type of seizures do they have? How long since the last one? Are they regular with their meds? Do they have any triggers or auras?

If your pharmacy is anything like mine, it takes them FOR. EVER. to get the patient's ordered meds to the floor. Be agressive in getting their antiseizure meds in them, on time.

Remember that sleep deprivation and fever (something we see a lot of in the hospitalized patient) tends to lower the seizure threshhold.

Seizure pads, oxygen, and suction set-up are the basics for patients at risk of seizures in most hospitals. During a generalized seizure people's jaws often clench & trying to get a yankauer in there will do more damage than good. I've never seen the need to suction a patient following a seizure. If you have a patient on a continual pulse ox while they're seizing, the sat should pop right back up after the seizure. If not, the O2 will come in handy.

During a seizure stay calm. Freaking out is a complete waste of energy in any situation. I suggest you check out the Epilepsy Foundation's first aid tips, including the links on the right side of the page for convulsive, non-convulsive, and special situations. I printed these tips out for my daughter's teachers to help prepare them for her seizures.

http://www.epilepsyfoundation.org/about/firstaid/index.cfm

After a seizure many people are sleepy or a little disoriented. If the disorientation persists contact the doctor. It could be a sign of continuing subtle seizure activity.

I hope this helps!

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Specializes in Er/Cardiac.

Hi Diane

I know you talked about seizure in this thread long time ago but I just came across it now. My question for you is why we don't want to give someone who's seizing O2 via nasal canula? Is it because it's not enough or there is other reasons behind it?

cheers

Al

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stay with the pt then ask somebody to call for help. observe the pt's seizure, note the length, check 02 sat.

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Specializes in medical surgical.

I agree with the above but I would like to add that you may have to suction down the nares. If the family tells you the pt just had a seizure you need to ask several questions but watch the pt for their reaction because they maybe psuedo seizures. I have had patients that when a gave them a command during a so-called seizure, such as raise your hand, open you eyes, they responded. Stay calm and don't panic.

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I just had a quick question about this as well. If the patient begins to have a seizure in the hospital bed, do we lower the head of bed and then turn him or leave the head of bed where it is at and turn him on his side??

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The first and foremost action you want to do when a pt is seizing is to keep to the pt. safe. What we do in our emergency department I work is to lower the head of the bed and put the pt in his side or rescue position to keep the air entry open. One thing I found that we as nurses sometimes forget with pt who come with Dx of seizure is IV. Only because the pt is stable, talky walky when they come in doesn't mean they don't need an IV. If the pt started having status epileptius there's no way you can get an IV. And what we usually give to pt in these situation is Lorazepam IV. Any other thoughts on that?

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