SEIZURES AND UNCONSCIOUSNESS LESSON-25 BY JITENDER
Description: SEIZURES AND UNCONSCIOUSNESS LESSON-25 BY JITENDER YADAV INSPPH OBJECTIVES 2. List four steps for the pre-hospital treatment for seizures when arriving while the patient is still having a seizure. Upon completion of this lesson, you will
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slide1. SEIZURES AND UNCONSCIOUSNESS LESSON-25 BY
JITENDER YADAV
INSP/PH<br>
slide2. OBJECTIVES 2. List four steps for the pre-hospital
treatment for seizures when arriving
while the patient is still having a seizure. Upon completion of this lesson, you will be able to:
1. Define seizure. List five additional steps for the pre-hospital
treatment for seizures to take after the
seizure is over. 4. List the causes of temporary loss of
consciousness and the steps of management.<br>
slide3. SEIZURES If the normal functions of the brain are upset, its electrical activity can become irregular. A sudden and temporary change in mental
status cause by massive electrical discharge
in the brain. Seizures are caused by a nervous system
malfunction.<br>
slide4. A seizure can cause a sudden change in a person’s sensations, behavior and/or movements. Having seizures is not a disease in itself, but
rather a sign of some underlying defect,
injury or disease. Some seizures involve uncontrolled muscular
movements called convulsions.<br>
slide5. CAUSES OF SEIZURES Failure to take anti-seizure medication Cerebral vascular accident (CVA). Poisoning, including alcohol and drug
poisoning. Hypoglycemia. Epilepsy. Chronic medical conditions<br>
slide6. CAUSES OF SEIZURES Fever (most common in children under Age 6 Eclampsia (a severe complication of pregnancy). Hypoxia (decreased levels of oxygen in the
blood). Head injury or brain tumors. Infection. This lesson will cover three of the more
common causes of seizures, including epilepsy,
fever, and head trauma.<br>
slide7. EPILEPSY Epilepsy is an organic neurological illness, perhaps the best known of the conditions that causes seizures.
Some people are born with it and others develop it after a head injury or surgery.
Conscientious use of medication allows most epileptics to live normal lives without seizures.<br>
slide8. Epilepsy is an organic illness that can present itself in different forms.
Some episodes of convulsions are very pronounced (grand mal)
Some convulsions are almost undetectable (absence or petit mal).
An epileptic convulsive episode can repeat itself an indefinite number of times.<br>
slide9. FEBRILE SEIZURE Fever is a common cause of seizures in children less than 6 years of age.
It is the rapid rise in body temperature, rather than the temperature itself, that causes the seizure.
It can repeat itself many times. All children who have suffered a seizure require medical evaluation.<br>
slide10. HEAD TRAUMA A patient with a brain injury may have a seizure immediately or it might be delayed.
A hematoma may form inside the skull, causing increased pressure and resulting in a seizure.
It is very important to obtain a thorough patient history to determine whether the patient has fallen or received any type of head trauma.<br>
slide11. SIGNS AND SYMPTOMS OF A SEIZURE The most common type of seizure you will respond to is a grand mal, or generalized seizure.
There are four phases in this type of seizure:
1) Aura phase:
The patient becomes aware that the seizure is coming on, usually described as an unusual smell or flash of light, usually lasting only a second. Cont…<br>
slide12. 2) Tonic phase:
Patient becomes unresponsive and collapses. All the muscles of the body contract. The body becomes rigid and the patient may stop breathing. May become incontinent.
3) Clonic phase:
The patient convulses violently. May foam at the mouth or drool, and may become cyanotic.
4) Postictal phase:
Begins when convulsions stop. Patient gradually regains consciousness. Headache is common.<br>
slide13. Other common signs and symptoms for less severe seizures:
- Temporary loss of concentration or awareness.
- A typical behavior.
- Tingling, stiffening or jerking in one part of the body, which may later spread.<br>
slide14. A continuous seizure, or two or more seizures without a period of responsiveness is called status epileptics.
This is considered a true medical emergency, and can be fatal. Transport the patient immediately.<br>
slide15. PRE-HOSPITAL TREATMENT FOR SEIZURES Use universal precautions and secure the scene.
If you arrive while the patient is still having a seizure, begin at Step 1:
Place patient gently on the floor and move any objects that patient might strike.
Stay calm and wait. Do not force anything into the patient’s mouth. The seizure should be over in a few minutes.<br>
slide16. Loosen restrictive clothing. Do not restrain patient.
Place the patient on his/her side to prevent aspiration.
If you arrive after the seizure is over, begin at Step 5:
Assess and monitor airway and breathing.
Treat any injuries the patient may have sustained during convulsions.
Place the patient in recovery position (if you do not suspect spinal injury).
Administer oxygen if needed.
Comfort and reassure the patient.<br>
slide17. For febrile seizures in children, lower the patient’s temperature with tepid water with a bath sponge or wash cloth.
Transport the patient..<br>
slide18. UNCONSCIOUSNESS Unconsciousness or loss of consciousness is a common phenomenon faced by the medic at all locations
It may be:
temporary loss of consciousness as in syncope (blackout), seizures, vertigo etc
persistent loss of consciousness as in coma or brain death due to disorders of arousal mechanisms of brainstem or both cerebral hemispheres<br>
slide19. UNCONSCIOUSNESS Temporary loss of consciousness is most often due to impaired perfusion of brain for short periods and is a symptom of underlying disease or disorder
The patient often describes it as a funny sensation like lightheadedness, transient amnesia or vertigo (feeling of the room taking turns) or dizziness
The sensation of movement or vertigo is often due to alteration of function of the peripheral balance maintaining organs or central control mechanisms of balance or posture<br>
slide20. CAUSES OF UNCONSCIOUSNESS The feeling of lightheadedness or transient loss of consciousness (black out) may be due to large number of causes like
Hypoglycemia
Anxiety
Hyperventilation
Panic attack
Seizures
Post head injury
Aortic stenosis
Arrhythmia (rhythm disturbance of heart)
Transient ischaemic attack of CVA<br>
slide21. MANAGEMENT OF UNCONSCIOUSNESS Protection of patient from collapsing suddenly and sustaining further injury
Ensure patient is in supine position with head end lower to encourage better cerebral perfusion.
Maintain open airway
Administer oxygen high flow until patient is stabilized
Any of the above causes need a detailed investigation and urgent referral for further evaluation and management<br>
slide22. ANY QUESTION
?<br>
slide23. THANKS<br>
JITENDER YADAV
INSP/PH<br>
slide2. OBJECTIVES 2. List four steps for the pre-hospital
treatment for seizures when arriving
while the patient is still having a seizure. Upon completion of this lesson, you will be able to:
1. Define seizure. List five additional steps for the pre-hospital
treatment for seizures to take after the
seizure is over. 4. List the causes of temporary loss of
consciousness and the steps of management.<br>
slide3. SEIZURES If the normal functions of the brain are upset, its electrical activity can become irregular. A sudden and temporary change in mental
status cause by massive electrical discharge
in the brain. Seizures are caused by a nervous system
malfunction.<br>
slide4. A seizure can cause a sudden change in a person’s sensations, behavior and/or movements. Having seizures is not a disease in itself, but
rather a sign of some underlying defect,
injury or disease. Some seizures involve uncontrolled muscular
movements called convulsions.<br>
slide5. CAUSES OF SEIZURES Failure to take anti-seizure medication Cerebral vascular accident (CVA). Poisoning, including alcohol and drug
poisoning. Hypoglycemia. Epilepsy. Chronic medical conditions<br>
slide6. CAUSES OF SEIZURES Fever (most common in children under Age 6 Eclampsia (a severe complication of pregnancy). Hypoxia (decreased levels of oxygen in the
blood). Head injury or brain tumors. Infection. This lesson will cover three of the more
common causes of seizures, including epilepsy,
fever, and head trauma.<br>
slide7. EPILEPSY Epilepsy is an organic neurological illness, perhaps the best known of the conditions that causes seizures.
Some people are born with it and others develop it after a head injury or surgery.
Conscientious use of medication allows most epileptics to live normal lives without seizures.<br>
slide8. Epilepsy is an organic illness that can present itself in different forms.
Some episodes of convulsions are very pronounced (grand mal)
Some convulsions are almost undetectable (absence or petit mal).
An epileptic convulsive episode can repeat itself an indefinite number of times.<br>
slide9. FEBRILE SEIZURE Fever is a common cause of seizures in children less than 6 years of age.
It is the rapid rise in body temperature, rather than the temperature itself, that causes the seizure.
It can repeat itself many times. All children who have suffered a seizure require medical evaluation.<br>
slide10. HEAD TRAUMA A patient with a brain injury may have a seizure immediately or it might be delayed.
A hematoma may form inside the skull, causing increased pressure and resulting in a seizure.
It is very important to obtain a thorough patient history to determine whether the patient has fallen or received any type of head trauma.<br>
slide11. SIGNS AND SYMPTOMS OF A SEIZURE The most common type of seizure you will respond to is a grand mal, or generalized seizure.
There are four phases in this type of seizure:
1) Aura phase:
The patient becomes aware that the seizure is coming on, usually described as an unusual smell or flash of light, usually lasting only a second. Cont…<br>
slide12. 2) Tonic phase:
Patient becomes unresponsive and collapses. All the muscles of the body contract. The body becomes rigid and the patient may stop breathing. May become incontinent.
3) Clonic phase:
The patient convulses violently. May foam at the mouth or drool, and may become cyanotic.
4) Postictal phase:
Begins when convulsions stop. Patient gradually regains consciousness. Headache is common.<br>
slide13. Other common signs and symptoms for less severe seizures:
- Temporary loss of concentration or awareness.
- A typical behavior.
- Tingling, stiffening or jerking in one part of the body, which may later spread.<br>
slide14. A continuous seizure, or two or more seizures without a period of responsiveness is called status epileptics.
This is considered a true medical emergency, and can be fatal. Transport the patient immediately.<br>
slide15. PRE-HOSPITAL TREATMENT FOR SEIZURES Use universal precautions and secure the scene.
If you arrive while the patient is still having a seizure, begin at Step 1:
Place patient gently on the floor and move any objects that patient might strike.
Stay calm and wait. Do not force anything into the patient’s mouth. The seizure should be over in a few minutes.<br>
slide16. Loosen restrictive clothing. Do not restrain patient.
Place the patient on his/her side to prevent aspiration.
If you arrive after the seizure is over, begin at Step 5:
Assess and monitor airway and breathing.
Treat any injuries the patient may have sustained during convulsions.
Place the patient in recovery position (if you do not suspect spinal injury).
Administer oxygen if needed.
Comfort and reassure the patient.<br>
slide17. For febrile seizures in children, lower the patient’s temperature with tepid water with a bath sponge or wash cloth.
Transport the patient..<br>
slide18. UNCONSCIOUSNESS Unconsciousness or loss of consciousness is a common phenomenon faced by the medic at all locations
It may be:
temporary loss of consciousness as in syncope (blackout), seizures, vertigo etc
persistent loss of consciousness as in coma or brain death due to disorders of arousal mechanisms of brainstem or both cerebral hemispheres<br>
slide19. UNCONSCIOUSNESS Temporary loss of consciousness is most often due to impaired perfusion of brain for short periods and is a symptom of underlying disease or disorder
The patient often describes it as a funny sensation like lightheadedness, transient amnesia or vertigo (feeling of the room taking turns) or dizziness
The sensation of movement or vertigo is often due to alteration of function of the peripheral balance maintaining organs or central control mechanisms of balance or posture<br>
slide20. CAUSES OF UNCONSCIOUSNESS The feeling of lightheadedness or transient loss of consciousness (black out) may be due to large number of causes like
Hypoglycemia
Anxiety
Hyperventilation
Panic attack
Seizures
Post head injury
Aortic stenosis
Arrhythmia (rhythm disturbance of heart)
Transient ischaemic attack of CVA<br>
slide21. MANAGEMENT OF UNCONSCIOUSNESS Protection of patient from collapsing suddenly and sustaining further injury
Ensure patient is in supine position with head end lower to encourage better cerebral perfusion.
Maintain open airway
Administer oxygen high flow until patient is stabilized
Any of the above causes need a detailed investigation and urgent referral for further evaluation and management<br>
slide22. ANY QUESTION
?<br>
slide23. THANKS<br>