1. SEIZURE PROTOCOL Ottawa Inner City Health March 2009

2. Seizure A seizure is a sudden release of energy by the brain. It can cause a change in how a client acts.

3. Who is at Risk for a Seizure

4.  Alcohol and substance use and withdrawal  Brain dysfunction  Head trauma  Fetal Alcohol Spectrum Disorder  Brain abscess secondary to IV drug use or dental abscesses  Epilepsy  Medications  Pain medication  Antibiotics  Medication used to treat HIV and TB  Liver or kidney failure

5. Substance use Sometimes the substances themselves can cause seizures  Cocaine  Amphetamines  Heroin  Solvents

6. Classifications  Two main types  Partial  Generalized

7. Partial Seizure Seizure activity starts in one area of the brain. Signs:  person may appear confused, drugged, drunk,  may wander  lip smacking  purposeless activity or repetitive motions such as fidgeting with clothing

8. Generalized Seizure Two types of concern with this population  Tonic-clonic  Absence

9. Tonic-Clonic Seizure  affects entire body body falls, stiffens, and jerks loss of consciousness may cry out, bite tongue, turn pale, or appear to stop breathing  loss of bladder and bowel control  fatigue and confusion afterwards

10. Absence Seizure  Loss of consciousness but no confusion afterward staring eye blinking eye twitching lip smacking jerking of hands  

11. What should you do if your client has a seizure? Management of Seizure

12. CCW Role  Documenting pre-seizure and post-seizure events.  Maintain seizure precaution  Prevent complications due to:  Injury  Vomiting

13. STAY CALM

14. Check the time.

15. Make sure client is safe

16. Clear area

17. Do not put anything in client’s mouth or between the teeth.

18. Don’t worry if there is extra spit in the client’s mouth.

19. Do not try to hold client still.

20. Roll the person on their side after the seizure subsides.

21. Talk gently to the person.

22. When to notify the Nurse

23. Documentation Important information  Time and duration of seizure  Type of seizure  Interventions you did for client  Behaviour before/after seizure including whether or not sleeps after seizure  Vital signs every 1-2 hours until fully awake

24. Understanding the difference between seizures and non-seizure activity is important to care of client. Is this a Seizure?

25. It is not a seizure if...  They can talk to you  They are asleep and you see their eyes moving under their eyelids  They have jittery movements that stop when you lay a hand on them  Even though they are staring at you...they startle with a loud noise.

26. What is not a Seizure Fainting Daydreaming

27.  Panic Attacks  Rage attacks

28.  Migraine  Movement Disorder

29. Questions? 