Emergency tips for epilepsy

General Care for an Epileptic Individual

And

Tonic Clonic SeizureConvulsive seizure with loss of consciousness, muscle stiffening, falling, followed by jerking movements.

Here are a few things you can do to help someone who is having a seizure of any kind:Many seizure types-such as generalized absence seizures or complex partial seizures, which involve relatively brief episodes of unresponsiveness- don’t require any specific first-aid measures.

W h a t t o d o i f s o m e o n e g e t s a c o n v u l s iv e s e iz u r e :

C h e c k f o r In ju r y

•Make sure the victim's mental state has returned to normal. One way to do this is to ask the person his or her name, the year, and your location.

•Look for any injury to the mouth and head.

W h a t T o D o I f S o m e o n e H a s A No n -Co n v u l s iv e S e iz u r e (staring blankly, confused, not responding, movements are purposeless)

1. Stay with the person. Let the seizure take its course. Speak calmly and explain to others what is happening. 2. If the patient is standing or sitting when seizure begins, ease him or her to the floor to prevent fall.3. Move dangerous objects out of the way. 4. D O N O T r e s t r a in t h e p e r s o n .

5. Gently guide the person away from danger or block access to hazards. 6. After the seizure, talk reassuringly to the person.

C a l l in g t h e A m b u la n c e

Most seizures due to epilepsy are not medical emergencies. They end naturally after a minute or two. There is usually no need to call for emergency help, unless, of course, the physician has advised it.H o w e v e r , a n a m b u la n c e s h o u ld b e c a l le d i f :

• It's the first seizure a person has ever had• Normal breathing does not start again after the shaking stops• There are injuries or the seizure happened in water• Other medical conditions, like diabetes, pregnancy or heart

disease are involved• The seizure is prolonged (goes on for more than five minutes

without any sign of stopping)• Another seizure starts soon after the first one• You are concerned that something else may be wrong

DOCUMENTATIONFacts that should be recorded when a seizure occurs include:

1. Documentation and description of aura if reported by the patient2. Circumstances in which the seizure activity occurred 3. Time of the onset of seizure activity 4. Muscle groups involved (and whether unilateral or bilateral)5. Total length of seizure activity6. Vital signs7. Behavior after seizure8. Neurologic status in postictal period (weakness or inactivity of a body part, sleep, amnesia, confusion, or headache)9. Documentation and assessment of any injury and documentation that injury has been reported to the proper person

Safety and Seizures

Safety and Seizures

•Accidents can happen at any time to anyone. People take risks every day, but sometimes risks people with epilepsy have to deal with can be different from those faced by others.

•Safety precautions should be sensible and relevant to the particular person involved, with a balance between risk and restrictions.

•With an awareness of potential risks and ways in which these can be lessened, activities can be much safer and most people with epilepsy can live full and active lives.

•Enjoy life as much as you can and don't restrict activities to a point where your interests and fun are excluded.

E v a lu a t in g P e r s o n a l R is k •U n d e r s t a n d t h e t y p e o f s e iz u r e : If you have drop attacks or convulsions, you have an increased risk of injury. Your risk is probably lower if you have brief staring episodes, or remain awake and aware during seizures, or have seizures only at night.

•F a l l d u r in g a s e iz u r e ? Loss of balance and falling increases the risk of fractures, cuts and bruises.

•Frequency of seizures – someone who has many seizures a day is more at risk.

R is k s

•Age – infants, children and older persons are more susceptible to injuries and accidents •Medications – people on multiple medications or very high doses may suffer side effects such as drowsiness, double vision, poor coordination •Participation in high risk activities – If the activity takes place at heights, near water, or near some other hazard, the risk of being hurt during a seizure goes up also included are drinking alcohol, taking drugs •Any other physical or neurological problems

E v a lu a t in g P e r s o n a l R is k

Id e n t i f y in g t h e w a r n in g s ig n s o r t r ig g e r s

If you do, changing activities to avoid the trigger as much as you can reduces the risk of related injury.

K e e p a n E p i le p s y d ia r y , s o t h a t f r e q u e n c y o f s e iz u r e s c a n b e u n d e r s t o o d .

S a f e t y T ip s -- D a i ly L iv in g Some people with epilepsy will not need (or want) to make any of these modifications to their lives.

• Make sure everyone in the family knows what to expect when you have a seizure, knows correct seizure first aid and knows when it is (or isn't) necessary to call for emergency help.

• Know first aid for choking. Make sure your family and friends do, too.

• Help young children in your family learn what to do by having "seizure drills" that review first aid steps and how to call for help.

• Avoid things which are known to increase the risk of a seizure -- for example, forgetting to take medication; not getting enough sleep; drinking a lot of alcohol.

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Common accidentsCommon accidents seen and ways to lessen the likelihood of accidents are listed below. It is important to remember this list is not exhaustive and some suggestions are not relevant to all people with epilepsy.T o r e d u c e l ik e l ih o o d o f c u t s , b r u is e s a n d a b r a s io n s•Reduce clutter, sharp or jutting edges and corners. •Use a shower curtain rather than a glass screen. Also use a shower chair if necessary. •Reinforced glass doors are preferable or apply safety film to existing glass. •Use non-breakable crockery and cordless electrical appliances with automatic switch off. •Minimise the use of knives by buying pre-sliced food when possible.• Prefer microwave cooking instead of Gas flame

T o p r e v e n t d r o w n in g•Never swim alone & avoid water sports•Ensure that the water is not too hot. •Wear an approved life jacket for water activities, including boating and fishing. •Showers pose less of a risk than a bath. If you only have a bath, use a hand-held shower attachment. •Do not shower or bathe whilst alone in the house if possible. •Shower at a time when seizures are less likely to happen. •Preferably have outward opening doors, sliding doors, half doors or doors that are easily removable fitted to the bathrooms. •Keep bathroom doors unlocked. •Turn the taps off before getting into the bath.

T o m in im is e s e r io u s in ju r ie s

•Avoid high-risk activities like using a ladder, rock climbing without a harness or flying foxes. •Wear helmets when riding a bicycle, scooter, horse, or when roller-blading or skateboarding. •Choose a low bed and avoid sleeping on a top bunk. •Stand well back from the road or platform edge when waiting for a bus or train. •Bathroom floors may be less hazardous if rubber-backed mats are used. •Avoid living in accommodation with stairs.

S u f f o c a t io n

•Try to sleep without a pillow or use a firm porous pillow. •Choose a low wide bed that has a firm mattress with a tightly fitted sheet. •An alarm may help alert parents or carers to seizures at night eg. baby monitor or intercom.

A v o id in g a c c id e n t a l o v e r d o s e o f a n t ie p i le p t ic m e d ic a t io n

•All medications should be locked away out of reach of children and not be left in pockets and handbags. •If a dose of medication is missed, the next dose should be taken as normal. Do not double the dose. •Discuss possible reactions with your doctor before taking any other prescribed medications or over the counter medications. •Consult the doctor before altering the prescribed medication regime. • Mark tablet foils for dates & months, using a marker pen (ease of dosing schedule)

S e iz u r e s d u r in g s le e p•Many families are concerned with the safety of their loved ones while they are asleep. This is of particular concern to parents of young children who have seizures and families of people living alone. •Family or parents should not stay awake watching for seizures. Everyone needs sleep, and this practice creates tiredness and dysfunction in the whole household. •Place a baby monitor in the child's bedroom so parents can hear any abnormal noises

In K i t c h e n s …

•Use a microwave oven rather than a stove. •If using a stove, use back burners. •Serve hot liquids or food onto plates at the stove rather than carrying them to the table. •Do not carry boiling water. •If possible, cook when someone else is home. •Use cups with lids. •Sit down to do tasks when possible. •Place sharp utensils downwards in the dishwasher. •Wear rubber gloves if washing glass or using sharp utensils. •Keep frequently used items within easy reach to avoid having to climb up to high cupboards. •Keep electrical appliances away from sinks.

W o r k p la c e S a f e t yWhen working around machinery, check for safety guards.

Try to keep consistent work hours so you don't have to go a long time without sleep.

If you are sensitive to flashing lights, try to limit your exposure. Look away if you can. Use dark glasses. Some people think blue lenses work best.

Does stress make your seizures worse? Is your job a very stressful one? If so, look at ways to reduce stress on the job.

Depending on your job and demands of the work site, consider wearing protective clothing if you have frequent seizures.

Keep a small pillow tucked away in a drawer so a co-worker (who knows where it is and what to do with it) can place it under your head if you have a generalized tonic clonic (grand mal) seizure.

Keep a change of clothes at work in case your clothes get soiled during a seizure.

T r a n s p o r t a t io n S a f e t y Avoid driving a car unless you have a valid license and are not having seizures.

Always wear a seat belt and insist your passengers do, too.

Stand well back from the road when waiting for a bus and from the platform edge when taking the subway or train.

To avoid wandering during a seizure, take a friend along when you travel.

If you have frequent seizures, the safety of taking a taxi cab instead of public transportation may be worth the extra cost.

C h i ld r e n ' s S a f e t y A monitor in the child's bedroom may alert you to the sound of a typical seizure.

Avoid top bunks. A lower bunk, a regular bed, a futon or even a mattress on the floor is a safer place to sleep for a child with seizures.

Choking is a risk for any child, especially if the child has frequent seizures and other disabilities. Children sometimes retain food in their mouths and it's a good idea to check if this is a problem.

Put a list of first aid steps in a place where it's easy to find Write down the phone number where you or a relative can be reached include the doctor's number and the one for the emergency squad on the same sheet.

M e d ic a l Id e n t i f ic a t io n

There are a number of reasons why we recommend wearing a medical ID bracelet if seizures are not fully controlled. Some of these include:•Many members of public do not know the correct first aid for a seizure. •Incorrect first aid such as putting something in someone's mouth or restraining them can cause injury to either party. •A large number of people would call an ambulance if they witnessed a seizure. •This is not always necessary and can prove an inconvenience for the person with epilepsy, mainly due to long waits in casualty and ambulance bills. •Some seizures may present as if the person is intoxicated or on drugs.

S a f e t y T ip s -- D a i ly L iv in g • Try using a pillbox to help you remember your medicines. Store

all medicines safely away from children.

• Wear a medical identification bracelet or card.

• If you have an aura (warning) before a seizure, lie down on your side on a carpeted or other soft surface.

• Carry a small portable phone or beeper in case you have to call for help and cannot get to a regular phone.

• If your seizures are very frequent and sudden, consider wearing a helmet or other protective clothing, such as knee or elbow pads, at least when you're at home alone.