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.