Seizures

What to do during a seizure

Generalized seizures: These seizures affect the entire brain and can cause a loss of consciousness, muscle spasms, and convulsions.
Focal seizures: Also known as partial seizures, these seizures only affect one part of the brain. They can be simple (no loss of consciousness) or complex (loss of consciousness).
Absence seizures: These seizures are typically seen in children, and they cause a brief loss of consciousness that lasts only a few seconds.

Myoclonic seizures: These seizures cause sudden, jerky movements in the arms and legs.
Atonic seizures: These seizures cause a sudden loss of muscle tone, often resulting in a person falling to the ground.
Tonic-clonic seizures: Also known as grand mal seizures, these seizures are the most recognizable type and involve convulsions and loss of consciousness.

Tonic-clonic Seizure

A tonic-clonic seizure, or grand mal seizure, affects both sides of the brain and leads to unconsciousness and convulsions. It starts with a stiffening of the body for up to 20 seconds, followed by jerking movements that can last up to 2-5 minutes. Breathing may stop or become irregular.

Absence Seizure

An absence seizure, also referred to as petit mal seizure, is characterized by a short-lived loss of consciousness that can last up to 15 seconds.

Priorities during a seizure, again

  • #1 Priority is to maintain patent airway
  • Have Oxygen and suction at the bedside
  • Do not put anything inside the child’s mouth
  • Do not restrain the child
  • Stay with the child
  • Side rails padded/ Keep only 2 siderails up.
  • Bed in the lowest position
  • Time the seizure
  • Side-lying post seizure

Welcome to your seizures

Matching

Important to monitor if taking Carbamazepine
Seizures that cause loss of consciousness and muscle spasms
Generalized Seizures
Major side effect of phenobarbital
Goal of anticonvulsants
Status Epilecticus
Detects seizure activity and locates the source of the seizure in the brain
Treatment for Status Epilecticus
Common trigger for seizures
To prevent injury during a seizure
Partial Seizure
Affects only half of the brain
Generalized seizures
To reduce frequency and severity of seizuers (do not cure)
A seizure lasting longer than 5 minutes or repeated seizures
EEG
Liver function tests
Sedation
Benzodiazepines such as midazolam
Provide safe environment
Affects the entire brain
Bright Flashing lights

Welcome to your seizures 2

Famous NCLEX Medication : Phenytoin

They have me on phenytoin (Dilantin) IV for my seizures.  Please follow these precautions:

  • Give it to me slowly.   About 1 to 3 mg/kg/min or 50mg / minute, whichever is slower, to prevent cardiovascular side effects
  • Check my Phenytoin levels (10 to 20 mcg/ml).
  • Give through a central line or large bore IV to prevent risk of extravasation/infiltration.
  • Only mix with normal saline.  Again, only normal saline. (Never D5W because it will precipiate, or any other medication). 
  • Use with caution if I have kidney or liver problems.
  • Monitor my skin for rashes and hives because of the risk of Steven-Johnson Syndrome.
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