Myth Busting: Treating Seizures
Over the past year, I’ve been writing a regular column for SisterShip Magazine. It’s a fun format where I take a medical myth and bust it wide open, replacing misinformation with the real thing. My goal, as always, is to educate boaters on handling medical emergencies on the water in a quirky and entertaining way. Please join me for the second installment where we address treating seizures.
When I was working as an ER nurse, I was always bucking to have a bright red “hot phone” installed in the department for anyone who was thinking of doing something dodgy. You call me and I’ll tell you what I think. For instance,”I’m thinking of letting my drunken mates pull me behind a pick up truck around a snowy field on the hood of an old car”, or “I’m planning on crossing the lake on my snowmobile since there’s not much open water”. And then I say, “Please don’t do that.” I could have saved so much embarrassment and so many lives.
In the world of offshore medicine, I am asked questions that make the words “Please don’t do that” spring forth again. Now my beloved red phone meets paper. We’re going to bust medical myths, call out the Old Wives, answer the questions that plague us and maybe learn a thing or two about handling medical emergencies on the water.
What Are Seizures?
Today we take on seizures. Watching someone have a seizure is a really scary thing and can leave us feeling powerless to intervene. We’ve all heard, read or seen in the movies when someone is having a seizure, we should stick something in their mouth so they don’t swallow their tongue. PLEASE DON’T DO THAT! It will not help and can potentially cause injury to the teeth and jaw.
The brain has zillions of cells called neurons that talk to each other using electrical impulses. A seizure is a burst of excessive electrical activity in the brain that can cause dramatic movements such as shaking, jerking, or lip smacking. Seizures can happen from a disorder called epilepsy. Epilepsy – which simply means that someone is at risk of having recurring seizures – can be an inherited disorder or be caused by conditions such as brain injury, stroke, brain infection or brain tumor. People are often given medication to keep this type of seizure from recurring. Though their seizures are controlled for the most part, something such as illness, stress, or forgetting to take their medication could bring on a seizure.
Non-recurring seizures can be caused by high fever, fainting, alcohol withdrawal, low blood sugar, certain drugs or a psychological condition. Once the problem causing the seizure is treated, it usually doesn’t come back.
What to do When Someone has a Seizure
What can we do? Regardless of the type of seizure or its cause, we have the power to intervene effectively. While we should never hold someone down, or try to “stop” the seizure, there are several things we can do.
Our most important job is to protect our “patient” from injury. Move hard or sharp objects like winch handles or glass out of the way. Place padding around the things you can’t move. Use whatever is handy: blankets, rolled up towels, or even fenders. Protect their head from banging on the deck by placing padding underneath or cupping their head gently in your hands. Remove eyeglasses and loosen any tight clothing from around their neck. Speak to them in a calm, soothing voice. Reassure them that you are close by and they are not alone.
The Role of the Tongue
Swallowing one’s tongue is impossible. That’s not even a real thing. The tongue is firmly attached to the floor of the mouth. The tongue, however, can be involved in two ways. Sometimes someone having a seizure will bite their tongue, lip or inside of the cheek, causing it to bleed. After the seizure is over, we can use some gauze and direct pressure to stop the bleeding. Have them gently rinse any blood out of their mouth when they have recovered enough to do so.
The muscles of the tongue can relax during a seizure causing the tongue to fall back a bit, which has the potential to block the airway, the same way it would during a cardiac arrest situation. After the seizure is over, we can use positioning to alleviate this problem. Roll them onto their side and gravity will move the tongue out of the way. It may seem that they are not breathing during the seizure, however even if they are not, they will usually start breathing again normally after it is over. If the seizure is over and they are not breathing, this is the time for the rescue breathing you learned in CPR class.
After a Seizure
Because a seizure causes massive electrical overload in the brain, the person is often very tired afterwards. We call this the postictal period. Don’t give them anything to eat or drink until they have completely recovered. Note the length of time the seizure lasted if you are able. Stay with them until they have fully recovered.
When do you need help? Follow up is necessary if this is the first seizure someone has had; if the seizure lasts longer than five minutes; if it seems that one seizure is immediately followed by another; if they are injured during the seizure; if they have significant underlying medical conditions such as diabetes, heart disease, or are pregnant; or if they had a seizure in water (inhaling water can damage the lungs). Emergency intervention is also required if they don’t wake up or have difficulty breathing afterward. The good news is that most seizures only last a few minutes and usually don’t require emergency medical attention.
An Internet search may give other remedies, but remember you can’t always trust Mr. Google. He’s only as good as the questions we ask him and he doesn’t have malpractice insurance!
Have a medical myth you want busted? Bring it on! Contact me and we’ll get to the bottom of it!
Medical Disclaimer: I am not a physician. I am an offshore medicine certified RN with 20+ years of ER experience and a heck of a lot of common sense. Follow up with your healthcare provider for any questions or concerns. Read my full disclaimer here.