How to care for a grand mal seizure and care during a seizure

Jining Renai Epilepsy Hospital teaches you the care of grand mal seizures:

For seizure care, remove any hard or dangerous things from the body, put a soft object under the head, untie the collar, cuffs, belt, and remove the dentures if you have dentures to allow the airway to be clear. There is no need to call or hold the patient desperately to try not to make him twitch, because no matter how hard you try at this point, it will not help or shorten the time for him to twitch.

When a grand mal seizure occurs there is more respiratory secretions, it is easy to cause airway obstruction or aspiration pneumonia. From the beginning of a major seizure, the patient's head should be turned to one side to allow the secretions to flow naturally, and the patient's collar and buttons should be unbuttoned to keep the airway open.

In the clonic phase, the muscles of the limbs contract, which can easily cause joint dislocation and abrasions of the limbs. At this time, the large joints of the limbs (such as shoulders, elbows, hips, knees) can be pressed with appropriate force to limit the amplitude of tics. But don't force too hard and force the pressure, as this can cause fractures or muscle damage.

For a grand mal seizure, the person is unwound from his trouser belt and the denture is removed. After the grand mal seizures have stopped, it takes a while for the patient to return to normal, which can be minutes, tens of minutes, or hours, and some patients are in a comatose state and only need to be allowed to sleep comfortably and quietly.

1.Prevent injury.

During the attack, the patient is placed on a flat stomach and a dental pad is placed between the patient's upper and lower molars to prevent tongue bites. There should be bed stalls, safety belts and other protective devices next to the patient's bed to prevent falling and collision injuries. Do not forcibly compress the patient's limbs to avoid muscle strain, fractures, joint dislocations, etc.

2.Prevents suffocation.

The head is tilted to one side during the attack to prevent the tongue from falling. Loosen the collar to cause saliva and vomit to flow out. If the patient has discharge or vomit from the mouth, it should be removed immediately to prevent aspiration.

Keep the airway open, if spontaneous breathing stops, immediately perform artificial resuscitation, and if possible, endotracheal intubation can be used to support breathing with a ventilator.

3.Use of anti-epileptic drugs.

Commonly used drugs include diazepam, sodium phenobarbital, hibernation drugs, etc. It is important to administer the medication exactly as prescribed. Pay attention to the speed of intravenous medication, closely observe the changes in the patient's breathing, heart rate and blood pressure, and pay attention to the adverse reactions of the drug. Remember to discontinue the drug after seizure control.

4.Observation of comorbidities.

Status epilepticus is often accompanied by oxygen deficiency, fever, cerebral edema, hydration, and medicine. Symptoms such as electrolyte imbalance and acid-base imbalance are original from Education Network. Oxygen inhalation, physical cooling, establishment of intravenous channels, and monitoring of electrocardiogram, blood gas, and blood electrolytes can be given symptomatically.

5.Keep records.

Accurately record the type, duration, and intervals of seizures. Record the name, dosage, method, time and effect of the medication. Before the seizures stop, a special person should be assigned to guard the disease so that changes in the condition can be observed and rescue measures should be taken in time.

Care measures for patients with epilepsy should pay attention to the following:

1. Psychological nursing. Epilepsy is a chronic disease, physical pain, family discrimination, social prejudice, seriously affect the physical and mental health of patients, patients often feel nervous, anxious, fearful, emotional instability, etc., always worried about recurrence. Therefore, family members should often give care, help, and love, and give timely guidance for ideological concerns, so that they can have a good living environment and a happy mood.

2. Medication care. Family members should supervise and inspect patients to take medicines on time and in accurate amounts, prevent underdoses, missed doses and more doses, and family members should not change drugs and doses at will, whether they increase or decrease drugs, as well as the variety of drugs to be replaced, they should be carried out under the guidance of doctors.

3. Seizure care. Once a seizure occurs, there is no need to panic, the patient should immediately lie flat with the head tilted to one side, quickly loosen the collar, and stuff the towel between the upper and lower teeth to avoid biting the tongue, and do not force the convulsive body to avoid fractures and dislocations. If status epilepticus occurs, you should be sent to the hospital for medical attention.

4. Observation of the condition. Fully understand the characteristics of the patient's seizures, such as the triggers, places, seizure time, seizure aura, duration, etc., and introduce the detailed situation to the doctor, and carry out targeted treatment.

Epilepsy care measures should be carried out according to the characteristics of epilepsy, seizures have the following situations: patients take drugs irregularly, blood concentration changes cause seizures, and color, bright light, sound, emotion, etc. are all factors that induce epilepsy, so these factors should be avoided as much as possible in nursing. If the patient has a grand mal seizure, there will be a severe lack of oxygen, and in the nursing care, the respiratory tract should be kept as clear as possible, and the patient should be given oxygen after the seizure.

Most people with epilepsy can take medication regularly**. Try not to let the patient get tired in daily life, pay attention to rest, and don't stay up late. Don't drink strong tea and coffee, don't drink alcohol. Try to avoid going out alone.

Care during seizures is generally aimed at preventing seizure collateral injury. What is an episodic side injury? In the event of a sudden seizure, you may fall into bed, fall, fall, bruise, fracture or contusion, etc., especially the brain contusion may be more serious, which must be prevented.

In addition, it is necessary to prevent tongue biting caused by the patient's teeth, and some even bite off the tongue. To prevent asphyxia, some patients with epilepsy will be accompanied by vomiting or substances and secretions from the throat, which will flow into the trachea and cause suffocation. Therefore, epilepsy patients should tilt their head to one side to prevent suffocation when they have a seizure, and they must pay attention to this kind of problem.

If the patient has difficulty breathing, supplemental oxygen may be needed, the airway may be opened, the head tilted back, the airway opened, and so on. If the patient's clenching is obvious, gauze, chopsticks, or bamboo sticks wrapped in cotton cloth should be placed between the teeth to prevent excessive clenching, biting or tooth damage. Also pay attention to seek medical attention in time and call 120 in time.

The care of epilepsy patients should be divided into several aspects: first, it is necessary to develop good living habits, such as not staying up late, not using mobile phones and watching TV excessively, and not drinking alcohol; The second is diet, avoid eating some stimulant things, such as coffee, ginseng and cordyceps and other special supplements. The third is to take some precautions at home, pay attention to the corners of the wall and sharp objects, and avoid collisions during convulsions; Fourth, avoid strenuous exercise and avoid excessive fatigue.

1. It cannot limit seizures. If the limb cannot be pressed or flexed firmly during convulsions, this may cause accidental injury.

2. Do not put anything in the patient's mouth or between the teeth, such as placing wooden chopsticks, spoons, etc., especially pay attention to the fact that some family members are worried about biting the tongue when the patient has a seizure, and put their fingers between the patient's teeth in a hurry, this practice is absolutely prohibited, and it will cause unnecessary harm to the family.

3. Do not move the patient unless the patient is in danger.

4. Do not give the patient anything to eat or drink until he or she has fully recovered.

5. Do not use any measures to try to wake up the patient. If a grand mal seizure lasts more than 5 minutes, or if one seizure is followed by a second seizure, if the patient does not regain consciousness between two seizures, and if the seizure occurs if the patient is traumatized, an ambulance must be made in time.

Once a seizure occurs, family members or caregivers should not panic, and should immediately make the patient lie flat with his head tilted to one side, quickly loosen the collar and trouser belt, and do not forcibly press the convulsive limb to avoid fractures and dislocations. If status epilepticus occurs, take it to the hospital** in time to stop the seizures as soon as possible.

1. Drug treatment: The general principles of drug treatment for epilepsy are: early medication, sufficient dose, accurate medication, and long time.

Once the diagnosis of epilepsy is established, medication should be taken immediately to control the occurrence. The dosage meets the requirements of controlling epilepsy and does not present drug toxicity, and blood drug concentrations can be checked if necessary. Depending on the type or syndrome of epilepsy, the choice of medication is determined.

Generally, the drug can be discontinued only after more than 2 years of discontinuation.

2. Neuromodulation treatment: This is a new type of epilepsy treatment method, which combines magnetic disturbance skills, EEG pacing skills, bionic biofeedback skills, and internal environment regulation skills as one of the modern treatment skills. By regulating the abnormal electrical condition of the brain, it can improve the metabolic conditions of the brain, regulate the autonomic nerve function, and change the internal environment of the human body to press the abnormal discharge of the brain.

It encompasses advanced neuromodulation and treatment skills, while avoiding the toxicity and dangers of drug treatment and the surgical process.

3. Dietary treatment: Dietary epilepsy treatment mainly refers to the ketogenic diet**. This type of epilepsy is treated by choosing a diet that is high in fat and low in protein and carbohydrates, and causes ketones to occur in the body to mimic the body's response to hunger.

For epilepsy that is difficult to control with drugs, a trial ketogenic diet can be considered, and it is necessary for the family to strictly follow the conditions of epilepsy professional hospitals, and strictly implement the diet plan for epilepsy treatment. Because of the need for their own skills monitoring, there are also certain dangers, patients and families should not practice privately.

4. Surgical treatment: The intention of surgical epilepsy treatment is to safely remove the brain arrangement that causes epilepsy, that is, the epileptogenic area (the initial area), as long as the epileptogenic area is removed, it will not occur after the operation. The condition for the success of the operation is the determination of the preoperative epileptogenic area, which requires a very professional evaluation team and neurosurgery team to work together.

At the same time, surgery for epilepsy treatment is risky and is generally not recommended.

Experts pointed out that once a patient has a seizure, family members should immediately step forward to support the patient and try to let him fall down slowly to avoid falling. At the same time, before the patient's lips are not tightly closed, quickly roll the handkerchief and gauze into a roll and place it between the patient's upper and lower teeth to prevent biting the tongue when the trismus is closed; People who have fallen to the ground and are facing the ground should be turned over to avoid airway obstruction. It should not be ignored that at this time, do not forcibly pry open the patient's mouth, otherwise it will cause the patient's teeth to loosen and fall out.

To prevent the patient's saliva or vomit from being inhaled into the trachea and causing ventricular breathing, the rescuer or family member should always be by the patient's side and wipe off the patient's vomit at all times.

Finally, do not press the patient's limb to avoid fractures. Pay attention to the patient's heart and respiratory condition, give oxygen in the continuous seizure state, and if the breathing fails to recover in time after convulsions, artificial respiration should be done and sent to rescue in time.

First aid for seizures:

1.If the patient has a hunch, immediately go to a safe place and call family members or passers-by for help.

Step 1: Lie the patient flat and try to keep the patient in a safe environment to avoid secondary injury. For example, on the road**, the patient's family or passers-by call for help to create a safe area for the patient, but at the same time, leave a certain space for the patient to keep the air smooth.

Step 2: Turn the patient's head to one side to keep breathing smooth to avoid suffocation caused by vomiting and secretions blocking the trachea.

Step 3: If the patient has limb movements during the seizure, do not press the patient hard to avoid excessive force causing secondary injury.

Step 4: Do not move the patient during the seizure, usually the seizure lasts for a few minutes, after which it will recover on its own. If the seizure lasts for a long time, call the emergency services immediately** and wait for the ambulance personnel in place.