First Aid for Seizures, Seizures in Wheel-Chair Bound Patients and First Aid for Seizures in Water

Seizure Disorder which is commonly referred to as Epilepsy or Fits is quite a common neurological disorder characterized by sudden burst of electrical activity within the brain. This electrical activity is normally triggered by certain chemical changes occurring in the nerve cells of the brain. This results in the individual tending to lose muscle control, falling unconscious, or have severe bouts of involuntary twitching. There are different types of seizures based on the symptoms shown by the individual. However, the most common form of seizure is the generalized tonic clonic seizure.^[1]

It is estimated that approximately 75% of cases of seizures can be well controlled by medications alone.^[2] However, an individual with seizure disorder always has a risk of injuring self or others due to the unpredictable nature of this disorder. This is especially true in types of seizures where the affected individual loses awareness of the surroundings or there is no warning of a bout of seizure. If an individual with seizure disorder is left untreated, it may pose serious threat to the patient.

Risks due to seizures multiply when the individual has uncontrolled seizures. This is noted in people who are either not treated or are not compliant with physician recommendations. The most common type of injury due to seizure is a fall which can sometimes be very serious, especially when at high altitudes. The overall risk from seizure depends on the type of seizure, the compliance towards treatment, and lifestyle. Thus it is always better to adhere to physician recommendations in cases of seizure disorder and reduce the risks associated with it.

It is equally important for the family members of the patient to have knowledge of what first aid to give in cases of an unprovoked seizure. The following article gives a detailed review of what first aid should be given for individuals who have seizure disorder.

Practice the following steps for individuals with generalized tonic-clonic seizures where the body stiffens up and there is involuntary jerking:

• Do not panic and stay close to the patient
• In case if the onset of seizure is during eating then gently remove the food from the mouth or else it may cause choking
• Take the patient to a place where there is no danger of any injury
• Loosen their clothing and place something under the head
• Try to talk with the patient and give encouragement till the patient recovers from the bout of seizure
• In the best interest of the patient, try and note down the time duration of the event which can be used by the physician to analyze the type of seizure and make a suitable treatment plan
• Once the jerking ceases roll the patient to the side and allow him to rest
• Never give anything to the patient orally or try and restrain the patient unless they pose a threat to themselves or others.^[3]

If an individual is wheelchair bound or restrained such as when in a car then the following first aid should be given:

• Do not remove the seatbelt unless it poses a threat to the patient
• Stop the wheelchair from moving
• Try and hold the head of the patient till the time the seizure resolves
• Tilt the patient to one side so that any fluid or saliva accumulated in the mouth gets drained
• Once the seizure resolves then gently lift the patient from the wheelchair and put him on a bed. Allow the patient to take rest or sleep to allow them to come back to normal.
• In case of the patient has problems with breathing then it is always better to take him to the hospital for an evaluation. A CPR should be given if it is noticed that the patient has stopped breathing.^[4]

In cases where an individual has a seizure while swimming or under water then the following first aid should be given:

• Bring the patient to the surface of the water such that his head is out in the open. This will allow him to breathe normally and prevent any chances of drowning
• One can also tilt the head backwards such that all the airways are open and the patient is able to breathe normally.
• When the seizure resolves bring the patient out of water
• In cases of a prolonged seizure where the jerking movements do not cease then one can take help from others to bring the patient out of water
• Once the patient has been taken out of water take him to the nearest emergency room to rule out any chances of the patient swallowing water and if so proper treatment can be given to drain the excess water out of the lungs
• In case of the patient stops breathing, CPR should be given and the patient should be taken to the emergency room for treatment.
• When to call an ambulance for an epileptic seizure.^[5]

Immediate medical treatment is necessary for patients with seizure disorder in cases where they have a seizure and the following occurs:

• Duration of the seizure is for more than 5 minutes
• The patient immediately has another seizure as soon as the first one ends
• The patient is nonresponsive even after the seizure resolves
• The patient is not able to breathe normally even after the seizure ends
• The patient has a first full blown seizure
• Seizures that occur under water either in a pool or sea.^[6]

If an individual has a known diagnosis of a seizure disorder, the most important thing for that individual is to follow the physician’s recommendations diligently. Some of the general recommendations that physician’s give to people with seizure disorder are

• Never drive alone, use dangerous machinery, or travel at high altitudes. It should be noted that it is illegal for people with known seizure disorder to drive alone the duration of which depends on various factors like case of seizure, type of seizure, frequency of and episodes. Generally, the duration for which the patient cannot drive is decided by the physician.
• Never swim alone. In case if an individual has a seizure while swimming alone it may lead to potentially disastrous consequences like drowning
• Even if you have to swim, swim with a partner or wear a life jacket
• Avoid high altitude sports like bungee jumping or mountain climbing
• Avoid sports like scuba diving
• When showering always keep the bathroom door unlocked

Some of the general precautions that can be taken to prevent injuries in individuals with seizures are:

• Keep the home safe and patch any sharp ends that may be there
• Try and keep the floors as dry as possible to prevent any slip and fall in case of a seizure
• Always have high railing in balconies especially if you live in top floors of an apartment
• Try and not stay alone at home
• Wearing a medical identification bracelet also helps for individuals with seizure disorder.^[7]

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