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In this video, we will look at the process for dealing with convulsions where there are no time-critical features and with time-critical features as well. After assessing the patient and identifying that there are no time-critical features present, you should find out whether the patient has an individualized treatment plan. If they do, this should be followed. If not, you will need to ascertain the type of convulsion, if it is epileptic, febrile, or eclamptic. Consider what may be the cause. It could be due to hypoglycaemia, in which case, check the blood glucose level or temperature, which could also be due to an underlying infection. If it could be due to a head injury, check for any signs and symptoms. Other causes could include severe hypertension, or alcohol and drug abuse. Monitor the patient's heart rate and rhythm, but do not attempt to force an oropharyngeal airway into a convulsing patient, and the nasopharyngeal airway is a useful adjunct. Take care with the patient with a suspected basal skull fracture or facial injuries, position the patient for the best airway maintenance.

Administer oxygen during convulsions, administer at 15 litres per minute until reliable SpO2 measurements can be obtained. Aim for saturations with a range of 94% to 98%. After convulsions, administer supplementary oxygen if hypoxemic where the SpO2 level is less than 94%. Find out if any medication is being given. For example, a patient's own buccal midazolam. For a grand mal convulsion still continuing 10 minutes after the first dose of midazolam, recurrent diazepam or midazolam can be administered for seizures lasting more than five minutes. And where they are still having seizures or repeated seizures, it can also be administered in cases of status epilepticus or eclamptic seizures lasting more than two to three minutes, or where they are recurrent. Transfer the patient to further care if they are suffering from serial convulsions, eclamptic convulsions, or if it is their first convulsion, or when having difficulties monitoring the patient's condition.

If you are dealing with a patient with convulsions that do present time-critical features, you need to initially assess them. Having assessed the patient and identified that there are time-critical features such as major ABCD problems, serious head injuries, status epilepticus, following failed treatment, underlying infection, or eclampsia, start correcting any problems. Check blood glucose and undertake a time-critical transfer. It is vital to reach a hospital for definitive care as quickly as possible if the patient can be transferred despite convulsing. Provide an alert information call and continue to manage them en route to the hospital.