Em basic- seizures

EM Basic- Seizures

(This document doesn’t reflect the views or opinions of the Department of Defense, the US Army, or the Fort Hood Post Command © 2012 EM Basic LLC, Steve Carroll DO. May freely distribute with proper attribution)

Chart- read triage note, check vital signs, get full history from triage note/paramedics
Patients who are not actively seizing
-Get a thorough history of the incident

-Any preceding headache, vision changes, aura?

-History of seizure disorder or seizure medications?

-History of preceding trauma or fever?

-Ask bystanders what they witnessed

-Loose and floppy with shaking or tense all over?

-Eyes open or eyes tightly shut?

-How long did it last?

-Shaking all over or just one extremity?

-Bowel or bladder incontinence?

-Confusion after the seizure (post-ictal period)?
PEARL- Patients with syncope can have a few non-sustained myoclonic jerks that aren’t seizures. On the flip side- make sure this “seizure” wasn’t syncope. Syncope is a rapid loss of consciousness and postural tone with a rapid return to baseline. Have a low threshold for an EKG.

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