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CH_20student - Ch 20 Seizures Dizziness Seizures and...

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Unformatted text preview: Ch. 20- Seizures, Dizziness, Seizures, and Fainting Seizures • An involuntary, sudden change in sensation, An behavior, muscle activity, or level of consciousness that results from irritation or overactivity of brain cells cells • happen because of sudden, abnormal electrical happen activity in the brain. activity • 10% of Americans will experience a seizure in their lifetime. Causes of Seizures • Causes of Seizures – Epilepsy-A chronic brain disorder characterized by recurrent seizures not caused Epilepsy-A by acute problems, with or without loss of consciousness by – Acute head injury or stroke – Low oxygen levels in the brain – Drugs or alcohol – Derangements in the body’s chemistry – Trauma or other injury to the brain that causes scar formation – Reduced blood flow to the brain – Inflammation of the brain, usually caused by bacterial, viral, or parasitic infection – Fever, usually in children 6 months to 3 years old – Degeneration of the central nervous system, such as from multiple sclerosis – Congenital brain defects – Brain tumor – Hypoglycemia or hyperglycemia – Severe burns – Endocrine changes during pregnancy or menstruation Types of Seizures • Focal seizures, also called partial seizures, happen Focal in just one part of the brain. • Generalized seizures are a result of abnormal Generalized activity on both sides of the brain. activity • generalized tonic-clonic (grand mal) seizure A generalized convulsive seizure characterized by alternating muscle rigidity and jerking, temporarily suspended breathing, and altered mental state breathing, • absence (petit mal) seizure A seizure absence characterized by a blank stare that lasts only a few seconds, most common in children; an absence seizure does not involve convulsions seizure Types of Seizures • Simple partial (Jacksonian) seizure- A simple, partial Simple seizure characterized by jerking in the fingers and toes; the jerking may spread to involve the entire arm or leg, but the victim stays awake and aware. It may progress to a generalized tonic-clonic seizure generalized • Complex partial (psychomotor) seizure- A seizure that Complex starts with a blank stare, then progresses into chewing or other random, repetitive activity; the victim seems dazed • Myoclonic seizure- A seizure characterized by sudden, Myoclonic brief, massive muscle jerks that involve part or all of the body body • Atonic seizure- Also called a “drop attack,” a seizure in Atonic which the legs of a child suddenly and temporarily collapse collapse Stages of a Seizure 1. The aura, a peculiar “warning” sensation that lasts only a few seconds (it 1. aura peculiar may be visual or auditory hallucinations, a peculiar taste in the mouth, or a painful sensation, for example) painful 2. The tonic phase lasts 15 to 20 seconds; the victim loses consciousness, 2. tonic there is continuous muscular contraction, and the victim stops breathing. there 3. The hypertonic phase lasts 5 to 15 seconds; there is extreme muscular 3. hypertonic rigidity. 4. The tonic-clonic phase lasts 30 to 60 seconds; muscular rigidity and 4. relaxation alternate rhythmically and in rapid succession, there is frothy saliva, and the victim may lose bowel and bladder control. saliva, 5. Autonomic discharge lasts for a few seconds; there is hyperventilation, 5. Autonomic salivation, and rapid heartbeat. salivation, 6. During the postseizure phase, the victim lapses into a coma. 6. postseizure 7. The postictal phase- (recovery phase) usually lasts 5 to 30 minutes, but 7. occasionally several hours; all muscles relax and the victim slowly becomes responsive but remains exhausted. responsive Assessment • • • • • • • What the seizure was like Whether the victim has a history of seizures Whether the victim takes medication for seizures How the seizure progressed Whether the victim has suffered a head injury Whether the victim uses drugs or alcohol Whether the victim has diabetes mellitus Whether In performing a physical assessment, pay particular attention to the following: following: • Signs of injury to the head, tongue, or elsewhere on the body • Signs of drug or alcohol abuse (such as alcohol on the breath or needle Signs tracks) tracks) • The victim’s mental status • Fever • Presence of a Medic Alert tag or other identifying medal or bracelet First Aid for Seizures 1. Do not move the victim unless he or she is near a dangerous object that cannot be 1. moved. Otherwise, move objects away from the victim. Place padding under the victim’s head to prevent injury. 2. Maintain an open airway. 2. 3. Stay calm; if the victim is responsive, reassure him or her; reassure others who are 3. with the victim. with 4. Stay with the victim until the seizure has passed; if you need to get help, send 4. someone else. someone 5. Never try to force anything between the victim’s teeth, and never give the victim 5. anything by mouth. anything 6. Remove or loosen any tight clothing, especially around the neck; remove eyeglasses. 7. After the seizure, turn the victim on his or her left side with the face pointed downward 7. so secretions and vomit can drain quickly out of the mouth and so the tongue will not fall back and block the airway. fall 8. If the victim stops breathing, open the airway, remove anything that might impair 8. breathing, and provide artificial ventilation. 9. Do not try to restrain the victim unless he or she is in danger from objects that cannot be moved. be 10. Keep the victim from becoming a spectacle; ask bystanders to leave. 11. Following the seizure, reassure and reorient the victim; speak slowly and calmly in a 11. normal tone of voice. Allow the victim to rest; help the victim be as comfortable as possible. Stay with them for 15-20 minutes. possible. When to Call 911 • Call 911 if : - it is the persons first seizure -seizure lasts two minutes longer than their normal seizure -seizure lasts longer than 5 minutes -victim is injured from falling -victim stops breathing during or after seizure -victim does not awaken with 5 minutes after convulsions stop -Status Epilepticus Status Epilepticus Status • A severe, prolonged seizure lasting longer than five severe, minutes or a series of seizures that occur without the victim’s regaining consciousness between them the • • • Medical Emergency Call 911 Immediately Most serious threat is lack of breathing First Aid for Status Epilepticus 1. Call 911 2. Place the victim on the floor or bed, away from other 2. furniture. Do not try to restrain the victim. furniture. 2. Clear and maintain the airway; turn the victim’s 2. head sideways to prevent aspiration. head 3. Administer CPR as needed, even though it can be 3. extremely difficult to administer artificial ventilation to a seizing person. seizing 4. Carefully monitor vital signs until emergency 4. personnel arrive. personnel Vertigo • Vertigo- Dizziness Two Types: • Central vertigo- The least common Central type, mimics a transient ischemic attack or stroke; victims do not experience nausea, vomiting, hearing loss, or a whirling sensation hearing • Labyrinthine vertigo- The most Labyrinthine common kind of dizziness, caused by a disturbance in the inner ear and characterized by nausea, vomiting, and a whirling sensation vomiting, Signs & Symptoms of Vertigo Central vertigo – Dysfunction of the eye muscles – Unequal pupil size – Facial droop Labyrinthine vertigo – – – – – – Nausea Vomiting Rapid, involuntary twitching of the eyeball A whirling sensation Pale, moist skin Rapid heartbeat First Aid for Vertigo First 1. Reassure the victim; help the victim get in a 1. comfortable position and to move as little as possible. possible. 2. Conduct a thorough assessment to rule out any 2. immediate life-threatening conditions. immediate 3. Encourage the victim to see a physician. Syncope • Medical term for fainting • Sudden, and generally momentary, loss of consciousness, or blacking out, because of a lack of sufficient blood and oxygen in the brain. • Before they faint a person may experience dizziness, a dimming of vision, tinnitus, and feel hot • Caused by standing suddenly Causes of Fainting • • • • • • • • • taking in too little food and fluids low blood pressure hypoglycemia overexertion emotional distress lack of sleep standing up too quickly being in a very hot room More serious causes of fainting include cardiac causes such as an abnormal heart rhythm First Aid for Fainting 1. If the victim has not yet fainted, prevent him or her from falling by 1. having the victim sit down with head between the knees or have the victim lie on the floor with legs elevated 8 to 12 inches. victim 2. If the victim has already fainted, keep the victim in a supine position; 2. elevate the legs 8 to 12 inches. elevate 3. Monitor for possible vomiting; loosen clothing that might restrict free 3. breathing. breathing. 4. Make a rapid assessment for any life-threatening condition that may 4. have caused the fainting; initiate appropriate care. have 5. Check for any injuries that may have occurred during the fall; treat 5. appropriately. appropriately. 6. Do not allow a person who has fainted to sit up immediately. Instead, 6. have the victim sit up slowly and gradually. have 7. Help the victim feel better by moving him or her to fresh 7. air or by putting a cool, damp cloth on the face. ...
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This note was uploaded on 02/17/2011 for the course HK 280 taught by Professor Trembath during the Fall '07 term at Purdue.

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