Dr. Gil-Nagel, Director of the Epilepsy Program, explains how to deal with a seizure. There are many misconceptions about what to do, some of them very harmful.

By following the indications of the we will act correctly.

Correct attitude when witnessing a crisis:

When a person witnesses an epileptic seizure, he/she usually experiences a very intense impression, accompanied by fear and concern for the patient, while he/she may think that the affected person is about to die. However, the vast majority of epileptic seizures are not serious, cease by themselves in one or two minutes, and leave no after-effects. It is important to act correctly when witnessing a seizure, because although there is not much we can do to help the patient, inappropriate actions can cause harm and may be worse than the seizure itself. The following is a list of do’s and don’ts for helping a person during a seizure.

Yes, it should:

  1. Remain calm: The person will recover completely within a few minutes after the seizure. If breathing is interrupted, it will resume in a short time.
  2. Avoid shocks and other hazards. Never restrain him or interfere with his movements, except to prevent him from falling. Remove objects that could hit him, loosen tight clothing. If he walks aimlessly or is agitated, do not restrain him unless he is moving toward a danger zone.
  3. Address the patient with calm, non-threatening language.
  4. Lying on one side. After a generalized tonic-clonic seizure, when the seizures have ceased and the patient is drowsy, it is advisable to lay him on his side. In this way, if vomiting occurs, it will not pass into his lungs.
  5. Help the patient to breathe. It is important to ensure that the airway – nose and mouth – are clear. This is achieved by placing the patient on his or her side. It is not necessary to perform cardiorespiratory resuscitation when the diagnosis of seizure is clear.
  6. Observe. Paying attention to what happens during the crisis, with a view to reporting it to the physician, will be the key to a good diagnosis and therefore to an adequate treatment.

 

Do not:

  1. Forcing the mouth open or introducing objects into the mouth. It is a widespread belief that can have serious consequences. If in a crisis the jaw contracts and the tongue is bitten, this happens immediately, when we act it is too late and we cannot avoid it. Trying to open the patient’s mouth or introducing objects into it can cause injuries to the teeth and the temporomandibular joint. Placing objects in the mouth can also cause asphyxia if they move towards the throat.
  2. Interfering with their movements. Trying to suppress the convulsions duringthe crisis is counterproductive. Shaking the patient or pouring water on his face is of no use.
  3. Administering food or medication by mouth. During a seizure, swallowing mechanisms are altered, so the administration of medication or food may cause choking. Sometimes the physician will recommend administering medication during a seizure to prevent further seizures. These medications can be administered sublingually, nasally or rectally.

 

In short, in the face of a crisis …

  1. Keep calm.
  2. Artificial respiration is not necessary.
  3. Forcing the mouth open is counterproductive.
  4. Avoid hurting yourself.
  5. Help him/her breathe.
  6. Do not interfere with their movements.
  7. Watch closely everything that happens during the crisis.
  8. Wait patiently for the crisis to end.
  9. Do not administer medication by mouth.
  10. Once the crisis is over, no sedative is needed.
  11. Assess whether an ambulance should be called.

 

When should an ambulance be called?

Generally it is not necessary to call an ambulance or go to the emergency room, but it should be done in the following situations:

  1. When it is the first crisis this person has had.
  2. When it is the first seizure of this type that this person has had, even if his epilepsy was known to us.
  3. When it is a patient with epilepsy who is not taking his medication.
  4. When it occurs during an infectious process or is accompanied by fever.
  5. If injury has occurred during the crisis.
  6. If you have one crisis after another, without recovery of consciousness between them.
  7. When, one minute after the seizure has ended, the patient has not started breathing. In this case, an ambulance should be called and assisted respiration should be performed because it may be a cardiac problem and not an epileptic seizure.
  8. If the patient requests urgent medical assistance.
  9. If the crisis lasts more than fifteen minutes

 

Following these indications, we will act correctly in the event of an epileptic seizure.