There are a few different types of seizures, but we can break these down into two categories. The first is a partial, absent or petit mal seizure. The second category is the generalised seizure, also called convulsions, epileptic fits and grand mal. (petite mal and grand mal are older descriptions). There are also paediatric convulsions which I will deal with later in this blog. There can be a number different reason for the convulsion but a disturbance of electrical signals in the brain is often the main reason.
I was teaching First Aid recently and when we got to the seizures part of the syllabus, a student said that her young son had a fit and she cuddled him as tightly as she could (as she had been told). I was taken aback and informed her it was possible the worst thing she could have done and went on to teach her the correct procedure.
Dealing with partial or absent convulsions:
You will notice that the casualty is staring blankly for a few seconds or minutes. Make sure the casualty is safe and seat them if possible. Stay with the casualty and time the event. There can be mood swings beforehand and maybe some small twitching in the face and hands. KEEP CALM in all cases, speak to the casualty and monitor. When the come out of the partial seizure they may/may not remember what’s happened and they may be scared. If it’s the first seizure, ask them to go to their doctor.
Dealing with a generalised seizure or fit.
A generalised seizure can be frightening and very concerning, but there are steps you can take to help the situation before, during and after the event. The person who convulses often know it’s coming on but can’t tell you about it. When the casualty convulses (involuntary jerky movements of the arms, legs and head) KEEP CALM, make sure the area is safe and the casualty’s airway is open. Loosen clothing especially around the neck and take off their glasses if they are wearing them. DO NOT hold the casualty down. Record the duration of the seizure.
While the casualty is convulsing there’s little more you can do, but you can be helpful after they come out of the seizure. KEEP CALM and talk to the them, but don’t crowd over them. They may be nervous, tired, confused, dazed, embarrassed and edgy. They will be very tired as all their muscles have been firing off at the same time. Which also means that they may have lost control of their bowels and bladder. So offer a cover or an emergency blanket from your First Aid kit. After the casualty has come out of the seizure, they will need reassurance and if it’s their first fit, call an ambulance. Meanwhile, put them in the recovery position.
Children convulse quite naturally to control their body heat. They present the same as an adult convulsion, but the reason they fit is that they are too hot. They may have a chill, the room/car may be too hot, and they may be over dressed. Your skin is your biggest organ and we use it like a radiator in a car. If we’re cold, we shiver. If we’re too hot, we perspire. A child or baby doesn’t have the same area of skin and as such they can struggle to control their temperature. If this happens to a child or baby, KEEP CALM, lay them on the floor, cot or sofa, cool the area by opening windows, take their clothes off and fan them down. DO NOT put them in a bath of cold water or run them under water.
They will come out of the fit when their temperature moves back to normal. Call for the emergency services and monitor the child or baby until the medical team arrives.
I’ve dealt with several cases of people having fits and keeping calm is very important as is taking control of the situation. When the paramedics arrive, pass on any information you can to them i.e. name of the casualty, the time the convulsion started, and how long it lasted for, any action you’ve taken, and any medications they are on.
This is one of the skills I teach on my first aid courses, if you want to book onto a course or want more information then please call me on 07770 376497 or email me on email@example.com