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04-22-2004, 00:30

OK, I just can't let it get by without saying a few things.

1. Throw away those damn bite sticks! That is 50 year old medicine. The most often used purpose of the bite stick is to break teeth by well intentioned people. When a person has his Grand Mal SZ, One of the first actions is for the jaw to lock shut. Whatever tonque is bitten already happened and trying to stop it with a stick is a futile effort. If you must us an airway, a nasal trumpet is the way to go. And don't fight the poor guy. people have avulsed muscles off the origins and dislocated shoulders due to the good samaratin holding him down. And I have yet to see anybody swallow their tongues! Can't be done!(except Gene Simmons maybe) The base of the tongue may obstruct the airway, easily fixed by doing the head tilt or jaw thrust

2. There is an enormous pressure to DO SOMETHING! about a sz in process. A few said the right thing, protect the patient is the main thing. Most seizures will be self linited and do not require meds. By the book, meds aren't even indicated until the sz has lasted 15 minutes. A little O2 and suction is nice. The other thing you should do is sit back and " enjoy the show" Seriously, you may help the victim a whole lot more if you can give an accurate description of the sz to the Doc's. Is it unilateralor bilateral? Did it seem to start one place and spread? HOw long did it last? Were they at alll concious during the sz? Were the eyes deviated? Where? How long was the post-ictal period? Any other external factors?(trauma, drugs, meds, environmental exposure)

3. oh yeah, one other thing. What is the most common etiology for seizures that present ti an ER???

Noncompliance with their meds! Far and away the most common.

04-22-2004, 00:30	#13
Team4medic Guest Posts: n/a	Seizures OK, I just can't let it get by without saying a few things. 1. Throw away those damn bite sticks! That is 50 year old medicine. The most often used purpose of the bite stick is to break teeth by well intentioned people. When a person has his Grand Mal SZ, One of the first actions is for the jaw to lock shut. Whatever tonque is bitten already happened and trying to stop it with a stick is a futile effort. If you must us an airway, a nasal trumpet is the way to go. And don't fight the poor guy. people have avulsed muscles off the origins and dislocated shoulders due to the good samaratin holding him down. And I have yet to see anybody swallow their tongues! Can't be done!(except Gene Simmons maybe) The base of the tongue may obstruct the airway, easily fixed by doing the head tilt or jaw thrust 2. There is an enormous pressure to DO SOMETHING! about a sz in process. A few said the right thing, protect the patient is the main thing. Most seizures will be self linited and do not require meds. By the book, meds aren't even indicated until the sz has lasted 15 minutes. A little O2 and suction is nice. The other thing you should do is sit back and " enjoy the show" Seriously, you may help the victim a whole lot more if you can give an accurate description of the sz to the Doc's. Is it unilateralor bilateral? Did it seem to start one place and spread? HOw long did it last? Were they at alll concious during the sz? Were the eyes deviated? Where? How long was the post-ictal period? Any other external factors?(trauma, drugs, meds, environmental exposure) 3. oh yeah, one other thing. What is the most common etiology for seizures that present ti an ER??? Noncompliance with their meds! Far and away the most common.