Advanced Life Support (ALS) Level 3 (VTQ)

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Dealing with Convulsions: A Comprehensive Guide


Understanding Convulsions and Their Management

Dealing with Convulsions without Time-Critical Features

Assessment and Non-Urgent Procedures

When handling convulsions without time-critical features, follow these essential steps:

  • Assess the Patient: Determine if time-critical features are present.
  • Individualized Treatment Plan: Check if the patient has a personalized treatment plan and adhere to it.
  • Identify Convulsion Type: Determine if it's epileptic, febrile, or eclamptic.
  • Explore Potential Causes: Investigate underlying causes such as hypoglycaemia, infection, head injury, hypertension, or substance abuse.
  • Monitor Vital Signs: Keep an eye on heart rate and rhythm.
  • Airway Management: Be cautious with airway interventions; consider a nasopharyngeal airway.
  • Oxygen Administration: Provide oxygen at 15 litres per minute aiming for oxygen saturation between 94% to 98%.
  • Medication Check: Inquire about any medications already administered, such as buccal midazolam.
  • Recurrent Seizures: Administer diazepam or midazolam for prolonged or recurrent seizures.
  • Transfer to Further Care: Arrange transfer for serial convulsions, eclamptic convulsions, first-time convulsions, or difficulty monitoring the patient.

Dealing with Convulsions with Time-Critical Features

Immediate Assessment and Urgent Interventions

If convulsions present time-critical features, follow these crucial steps:

  • Initial Assessment: Evaluate the patient promptly.
  • Address Critical Issues: Prioritize major ABCD problems, severe head injuries, status epilepticus, underlying infections, or eclampsia.
  • Blood Glucose Check: Verify blood glucose levels.
  • Time-Critical Transfer: Arrange rapid hospital transfer if feasible despite ongoing convulsions.
  • Alert Information Call: Notify the healthcare facility to prepare for the patient's arrival.
  • Continuous Management: Continue providing care during transport to the hospital.