Status Seizures: A BLS Approach

摘要

Seizures are one of the more common EMS dispatches. Although most patients stop seizing prior to the fire department's arrival, some seizures continue after intervention. By definition, these patients are critical and require a great deal of attention. A seizure is a temporary change in behavior or consciousness caused by abnormal electrical activity in one or more neuron groups in the brain. A status or recurrent seizure is continuous seizure activity lasting 30 minutes or longer, without regaining consciousness. Although the definitions of both seizure and status seizure are important, the causes are far more significant to prehospital providers. Knowing the causes of seizures will help the first responder establish a treatment plan and minimize surprises. Seizures have multiple causes. Some are medical; others are environmental or trauma related. Common causes include stroke, head trauma, toxins, hypoxia, drug overdose, eclampsia (pregnancy related), tumor, infection, metabolic, epilepsy, hypoglycemia, and hypoperfu-sion. When considering the many causes of seizures, the most important point to remember is that seizures that continue without resolution are true emergencies. The actions of a competent first responder make the ultimate difference between positive and negative patient outcomes. When arriving at a seizure patient's side, it is important to gather a complete history of the event, including the patient's seizure history and prescribed medication; the occurrence of seizures; what the seizure looks like; possibility of cyanosis (bluish discoloration of the lips or skin); length of seizure; and the body parts affected by the seizure (localized or generalized).