Seizure Types and Nursing Management
Published on the 04 September 2016
Published on the 04 September 2016
Did you know that between two to five per cent of the population will suffer at least one seizure during their lifetime? (Greenwood et al. 2013) What would you do if someone had a seizure in front of you? Would you know how to describe what type of seizure it was? Would you know what to do to help the individual?
A seizure occurs when there is a disturbance within the brain caused by abnormal electrical discharges and neuronal activity. An individual will then be diagnosed with epilepsy if they have had two or more seizures that are unprovoked and not known to be a cause of a medical condition (Epilepsy Foundation 2014).
There are two major groups of seizures: primary generalised seizures, and focal or partial seizures. Primary generalised seizures involve both hemispheres of the brain at once, whereas focal seizures involve electrical disturbances in one specific area of the brain which may then spread to other areas of the brain. Partial seizures are generally a result of head injuries, infection, stroke, or tumours, whereas primary generalised seizure causes often involve hereditary factors (Epilepsy Foundation 2013).
Focal seizures can present in people as unusual behaviours and may appear as the person simply daydreaming. There are three types of focal seizures, including:
(Epilepsy Action Australia 2016)
Because generalised seizures are a result of abnormal electrical activity in both hemispheres of the brain, the individual will generally lose consciousness at the onset of the seizure (Epilepsy Action Australia 2016). Types of generalised seizures include:
(Epilepsy Action Australia 2016; Koutoukidis et al. 2013; Wehrle 2003)
Patient safety is one of the main considerations during seizure activity; it is important to remember DRSABCD:
The nurse must stay with the patient and call for help. It is important to note the time that the seizure started and its characteristics. Protection must be given to the patient’s head, especially with any convulsive movements occurring which may injure the patient. The surrounding area must be made clear to decrease the risk of injury, however it is important not to try to physically restrict the movement of the patient’s limbs as this can cause musculoskeletal damage. You can protect the patient from harming themselves by using pillows and bed rails if needed.
Attempts can be made to turn the patient in to the recovery position. If this is not possible, then it is essential to be done when the patient’s limbs relax, to prevent aspiration due to excessive saliva production, and ensure their airway remains patent. Suction and oxygen must be available, and if possible a soft oral airway can be placed providing you don’t have to force teeth apart to place it. Monitoring of vital signs is imperative, especially respiratory function.
Following the seizure it is important to continue to monitor the patient’s airway, using suction as needed, and allow the patient to sleep. When they wake, they may need to be informed on what has occurred and reassurance given, as this can understandably be quite distressing for the patient. Frequent monitoring of vital signs and neurological observations will need to be done on the patient to monitor their condition.
(Greenwood et al. 2013; Koutoukidis et al. 2013; Wehrle 2003)
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Sally Moyle is a rehabilitation nurse educator who has completed her masters of nursing (clinical nursing and teaching). She is passionate about education in nursing so that we can become the best nurses possible. Sally has experience in many nursing sectors including rehabilitation, medical, orthopaedic, neurosurgical, day surgery, emergency, aged care, and general surgery.