8(c) Dealing with seizure: overview and action stations!
A lot of this section is addressed to the carer, as the person whose help is critical when a person is having a seizure.
To witness a person having a seizure is disturbing. To understand what is happening may help. To understand what to do for a person in seizure is invaluable, and potentially lifesaving. Understand especially that the person watching may find it much more traumatic than the person having the seizure. While you cannot fail to be affected, try to distance yourself enough to watch and learn.
Seizure (having a fit) occurs when there is a surge of electrical activity through the brain, overwhelming control functions of one kind or another, also, in grand mal (aka tonic clonic) seizures, overwhelming consciousness. So in any seizure, there will be involuntary movements, and in the most severe, there will be loss of consciousness, and the person having the seizure then will have no recall of what has happened. In the seizure state, arms and legs may flail, the face be contorted and flushed, spittle flying, beyond the wildest orgasm, there may be lurching and lunging, often in a semi curled position.
A person suffering a seizure may find it embarrassing, even a matter of shame, to lose control in this way, or to have no recollection. How the sufferer copes may depend to a significant extent on how reassuring those around her or him are at the time. It may be helpful to see the event in the context of the brain trying to throw off a problem and settle normally again.
In the onset of any seizure, the person may become excited and passionate in speech and then start not to make sense. Eyes will roll; control of limbs diminishes — the higher brain functions are disabled, the brain stem (the dinosaur brain) is left to cope.
The greatest dangers to a person in seizure are:
• personal injury, from falling down or from thrashing about
• choking or asphyxiation, if there is any regurgitation from the stomach and breathing into the lung of material from the mouth.
Driving, operating machinery. Given that seizure may commence without notice and be entirely incapacitating swiftly, to drive or operate machinery while at risk exposes to risk not only the person with the tumour but also passengers and others on the road. There are relevant laws binding the driver and anyone knowing the person wishing to drive may be a risk. See section 10(c)
There are a couple of other important things that follow. If there is a known risk of seizure, especially of tonic clonic seizure, then it is desirable to make the living environment free of sharp objects that could be fallen upon.
If a person begins having a seizure, then there are some sensible things the observer can do:
• DON'T PANIC —the seizure is not destructive in itself, and it is up to you to see you can help and love and accept the involuntary movements and be there to help the person through the event;
• try to remember immediately to look at your watch or a clock —if there is a need to call an ambulance, the ambulance staff and hospital emergency staff will ask:
[1] how long did it last
[2] whether the person was conscious
[3] did the person hit anything, is there any injury; you are a valuable reporter, to assist in later interpretation of the event.In addition, it will help you to know that the event was over in say five minutes, because, especially the first time you go through this, those five minutes will seem much longer;
• do not try to restrain the person from involuntary movements — you won't succeed, you may hurt either or both of you, you may add to the muscle exhaustion of the person in seizure afterwards;
• see that the person is in a situation where they cannot fall or hit anything — if on a bed, either move the person away from the edge, or if that is difficult, be there to prevent falling from the bed; if on the floor, excellent, just get sharp objects out of the way, or covered by something soft;
• if the person has been eating, or if there is any indication of food rising from the stomach, it is best to try to get the person into what is known in first aid as the 'recovery position', off the back, onto the side, top leg bent up, so that the head can be over to the side and any regurgitated food has a chance to come out of the mouth rather than go back down to the lungs;
• in no circumstance try to hold the mouth open, or put anything in the mouth. Definitely don't try to administer oral medication, it's way too late and you can only cause choking. There is a risk that the tongue will be bitten, but that has to be lived with; your fingers or any mouth guard is likely to be crushed if put in the mouth, with further injury all round.
In essence, you are trying to allow the person to come through the event, without injury, and on his or her own.
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