Seizure Management – educate parents/patient
ACUTE MANAGEMENT:
Parents should stay calm and carefully observe the child. Remain nearby until he or she is fully alert, listen and reassure the child.
There is no need to restrain the child (this will not stop the seizure and may increase the child’s discomfort)
To prevent accidental injury, the child should be placed on a protected surface such as the floor or ground. Make sure surrounding is safe. Put something soft under his or her head.
To prevent choking, the child should be placed on his or her side or stomach. (recovery position)
When possible, the parent should gently remove all objects in the child's mouth, loosen tight clothing
The parent should never place anything in the child's mouth during a convulsion. Objects placed in the mouth can be broken and obstruct the child's airway.
Give diazepam liquid per rectal at the time of seizure to stop it. (kept in refrigerator, not freezer!)
If the seizure lasts longer than 5 inutes, the child should be taken immediately to the nearest medical facility for further treatment.
Do not give the child anything to drink until the child is fully alert
If known case of prev febrile fit,
Once the seizure has ended, the child should be taken to his or her doctor to check for the source of the fever.
This is especially urgent if the child shows symptoms of stiff neck, extreme lethargy, or abundant vomiting.
In an infant or child, if the seizure occurs with a high fever, cool the child gradually with tepid water. You can give the child acetaminophen, especially if the child has had fever convulsions before. DO NOT immerse the child in a cold bath.
Seek emergency care if
- has seizure lasting more than 5 min or is having repeated seizure
- has difficulty breathing
- turns a bluish colour in face, tongue or lips
- remains unconscious or unresponsive for more than a few minutes after seizure
- falls or hits his/her head during a seizure
- has a known heart condition
- looks ill
- has any symptom that concerns you
General Education
Febrile Fit
-tend to occur in children between 6 mth old to 3 yrs old, sometimes up to 6 yrs old
-occurs in a viral infection when temperature is rising rapidly
-differentiate it from rigor (on holding the hand, rigor can be stopped, but the jerking due to seizure cannot be stopped on holding the hand)
-risk of further febrile seizure is 1 in 3, further 1 in 3 will have 3 or more seizures
-Recurrence is higher if onset before 1 yr old and if there is positive family history
-usually benign course (1% develop epilepsy)
Epilepsy
-stress compliance to medication
-avoid trigger factors
-avoid swimming (unless there is 1 to 1 supervision, with 100% eye contact)
-don’t encourage cycling, climbing or scuba diving