Convulsions
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Dealing with Convulsions: A Comprehensive Guide
Introduction
Understanding Convulsions and Their Management
Dealing with Convulsions without Time-Critical Features
Assessment and Non-Urgent Procedures
When handling convulsions without time-critical features, follow these essential steps:
- Assess the Patient: Determine if time-critical features are present.
- Individualized Treatment Plan: Check if the patient has a personalized treatment plan and adhere to it.
- Identify Convulsion Type: Determine if it's epileptic, febrile, or eclamptic.
- Explore Potential Causes: Investigate underlying causes such as hypoglycaemia, infection, head injury, hypertension, or substance abuse.
- Monitor Vital Signs: Keep an eye on heart rate and rhythm.
- Airway Management: Be cautious with airway interventions; consider a nasopharyngeal airway.
- Oxygen Administration: Provide oxygen at 15 litres per minute aiming for oxygen saturation between 94% to 98%.
- Medication Check: Inquire about any medications already administered, such as buccal midazolam.
- Recurrent Seizures: Administer diazepam or midazolam for prolonged or recurrent seizures.
- Transfer to Further Care: Arrange transfer for serial convulsions, eclamptic convulsions, first-time convulsions, or difficulty monitoring the patient.
Dealing with Convulsions with Time-Critical Features
Immediate Assessment and Urgent Interventions
If convulsions present time-critical features, follow these crucial steps:
- Initial Assessment: Evaluate the patient promptly.
- Address Critical Issues: Prioritize major ABCD problems, severe head injuries, status epilepticus, underlying infections, or eclampsia.
- Blood Glucose Check: Verify blood glucose levels.
- Time-Critical Transfer: Arrange rapid hospital transfer if feasible despite ongoing convulsions.
- Alert Information Call: Notify the healthcare facility to prepare for the patient's arrival.
- Continuous Management: Continue providing care during transport to the hospital.