Human brain is made up of billions of nerve cells or neurons. These neurons communicate through electrical and chemical signals. When there is any fault in the nerve cells, there is a sudden excessive electrical discharge that disturbs the normal activity in the brain. Abrupt and increased electrical discharge in the brain results in epilepsy, also known as a seizure disorder.
FIRST AID FOR EPILEPSY
It is important to know how to respond immediately when there is a person who is living with seizure. The first-line of response when a person has a seizure is to provide general care and comfort and keep the person safe.
WHAT TO DO IN THE EVENT OF A SEIZURE
- STAY with person and start timing the seizure.
- Remain calm and check for medical ID.
- Turn the person onto their SIDE if they are not awake and aware. Don’t block airway, put something small and soft under the head, loosen tight clothes around neck.
- Do NOT restrain.
- Keep the person SAFE Move or guide away from harmful objects.
- Do NOT put anything in their mouth. Don’t give water, pills or food until the person is awake.
- STAY with them until they are awake and alert after the seizure.
Most seizures end in a few minutes. First aid for seizures is aimed at keeping the person safe until the seizure stops on its own.
FIRST AID IN FOCAL SEIZURE
In focal seizures, the person may appear unresponsive and confused as their consciousness is impaired. Automatic movements such as smacking of the lips wandering, or fumbling movements of the hand may be present. He or she may display inappropriate behaviour that may be mistaken for alcohol/drug intoxication or psychiatric disturbance. The instructions to be followed are:
- Keep the person away from obstacles and from dangerous places
- Keep calm and talk with the person as they regain awareness after seizure
- Reassure the person that they are safe and that you will stay with them while they recover.
FIRST AID FOR GENERALIZED TONIC-CLONIC SEIZURES
- Cushion head, remove glasses
- Loosen tight clothing
- Turn on side
- Time the seizure with a watch
- Don’t put anything in mouth
- Look for I.D.
- Don’t hold down
- As seizure ends …… offer help
FIRST AID FOR EPILEPSY PATIENT CONFINED IN AWHEELCHAIR, SEATED IN A BUS, TRAIN
DON’T
- Try to stop the seizure.
- Put anything in the person’s mouth.
- Try to remove them from their seat. In most cases the seat provides some support
DO’S
- Protect the person by preventing them from falling if there is no seat belt
- Make sure the wheelchair or the. Stroller is secure.
- Protect the person by supporting their head. Something soft under the head will help, if there is no moulded headrest.
- Check whether you need to move any hard objects that might hurt arms and legs in particular.
- Consciousness usually returns within a few minutes.
- Reassure the person and tell them what has happened.
First aid for seizures occurring in water
A seizure in water is a life-threatening situation. Loss of consciousness is especially dangerous and emergency care must go beyond the routine procedures. The steps to be followed, if someone is having a seizure in water e.g ., bath, swimming pool:
Support the person in the water with the head tilted so the face and head stay above the surface of the water. Remove the person from the water as soon as the active movements of the seizure have ceased.
Check if the person is breathing and whether they have a pulse. If they are Not breathing but have a pulse start mouth to mouth resuscitation and immediately call ambulance.
Even if the person appears to be fully recovered, call an ambulance.
Person should have a full medical check as inhaling water can cause lung or heart damage.
If a seizure happens out of the water during swimming activity, the person should not continue with swimming or water sports that day, even if the person appears to be fully recovered.
WHEN SEIZURE OCCURS IN A CROWDED PLANE MILES ABOVE THE EARTH, THE RULES FOR
FIRST AID ARE DIFFERENT.
- Clear space by folding up seat arms. Ask a flight attendant to find new seats for the other passengers in the row.
- Lie the person down across the seats with the head and body turned on one side.
- Make sure that the airway is clear, and breathing is not obstructed. Arrange pillows or blankets to prevent the person’s head from hitting unpadded areas.
- When the seizure stops, help the person into a resting position in a single reclining seat.
- If the seizure continues for more than about 5 minutes or is immediately followed by another one, tell the flight attendant that the person may be experiencing a medical emergency and may need emergency care.
(This is an excerpt of a comprehensive article scripted by Dr. Raviraj Ghorpade, other parts of the article on epilepsy will appear later)
DR. RAVIRAJ S GHORPADE M.Ch (Neuro, NIMHANS)
CONSULTANT BRAIN & SPINE SURGEON
ADVANCED BRAIN AND SPINE SURGERY
BHS LAKE VIEW GROUP OF HOSPITALS -BELGAUM-10
