Seizure Management

Question: Would you be able to go through some basic procedures for seizures? We work with children with autism and a few of them have seizures. Will this information be covered in Red Cross childcare first aid training courses (vancouverfirstaid.ca/first-aid-courses/childcare-first-aid-courses)?

Types of Seizures

Patients of seizures can be divided into two different categories. Seizures can occur once in a lifetime from a blunt force trauma or hit to the head. When a patient has chronic seizures then the patient is likely epileptic. Patients that are epileptic are typically aware of the condition and can be medicated to reduce the severity and frequency of the seizure episodes.

Being Prepared

When working with children that are susceptible to seizures it is important to have good communication with the parents and caregivers of the child. Ask the parents or caregivers if the child has any triggers for the seizure and how to avoid the onset and frequency of the seizures. Some patients can also be aware if a seizure is oncoming so I would recommend having a plan in place when children advise you or your staff if they feel a seizure oncoming. Some patients can predict a seizure episode and give a warning as long as 60 seconds. The ideal situation would be if the patient advises the staff of a oncoming seizure and then place him or herself in the ideal position and place. The ideal position is with the victim flat on his or her back, with no furniture or material around the victim to avoid injury. If possible have a blanket or pillow behind the patients head to prevent the head from impacting the ground or floor too forcefully.

When the Seizure Happens

If a child has a seizure without warning I would quickly place the child onto the floor and move any furniture away from the patient to allow the extremities and the body to move freely without hitting anything. DO NOT try to restrain the child as the seizure is happening. DO NOT place anything into the child’s mouth as it will likely become a choking hazard. The rescuer(s) should also focus on protecting the child’s head by placing a blanket or pillow behind it. If none are available you can place your hands behind the child’s head (palm’s up) to protect the head from impacting the floor.

After the Seizure

The seizure will likely stop within one minute. The patient may be unconscious after the seizure so it is important for the rescuer to check the patient’s vitals and treat appropriately. If vitals are absent  contact EMS immediately and begin CPR. If the patient awakes from the seizure do not expect him or her to be fully conscious or aware immediately after. Expect the patient to be confused, unaware and disoriented for up to an hour after the seizure. Monitor the patient and if the patient’s condition does not improve contact EMS. Rescuers should also recognize and care for any other injuries as a result of the seizure (e.g. from hitting objects).

When to Contact EMS

If this is the first seizure episode or if the patient is not susceptible to seizures contact EMS. I would also contact the caregivers and let them know of the situation. Good communication between the staff, patients and the caregivers is essential in effectively managing patients that are susceptible to seizures.

If ever the situation does not improve or if the patient’s condition does not improve contact EMS. To learn more about managing seizures take a standard or emergency childcare first aid course. Seizure management and over a dozen other first aid topics are included in these Red Cross first aid courses. CPR training and the use of automated external defibrillator is also included.

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