# Seizure vs. Panic



## ryanbg (Sep 30, 2008)

The other day while I was working, (I'm a lifeguard), an elder man went down our waterslide, and he came out in a seizure-like state, convulsing, and arms perpendicular to his body. After a few seconds of being rescued and pulled to the side with head being supported, he stopped, shook off a bit and got out of the pool without assistance and was instantly fine. He had no other symptoms of a seizure, and I've seen this before, but not this intensity. So basically, my question is, how do I determine the difference between a seizure and this, in case further treatment/care is necessary. Not necessarily at work, but in my personal life if I encountered a situation like this for whatever reason. Thanks!


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## sixmaybemore (Sep 30, 2008)

It's possible it *was a seizure. There are many different kinds of seizure. I can't remember the name of the type you are describing - not a lot you can do if the person comes out of it, and can't be convinced anything happened. http://www.epilepsy.com/epilepsy/types_seizures


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## KEVD18 (Sep 30, 2008)

ryanbg said:


> So basically, my question is, how do I determine the difference between a seizure and this, in case further treatment/care is necessary.



go to medical school. seriously, thats the only way for you to be able to effectively diagnose and treat.

other than doing that, asses the patient according to your level of training, treat as appropriate, recommend that they be evaluated further by a physician, if they refuse document it and carry on with your day/life.

you cant save everyone. you cant fix stupid and you cant save the world. the very second you fully realize and accept that, 95% of the physical and emotional stress associated with emergency medicine flies away and never comes back.


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## sixmaybemore (Sep 30, 2008)

> you cant fix stupid



Don't we wish.


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## KEVD18 (Sep 30, 2008)

i dont. i very firmly believe in natural selection. there are without a doubt people too stupid to continue living and polluting the gene pool. allowing them to weed themselves out is a good thing.


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## sixmaybemore (Sep 30, 2008)

KEVD18 said:


> i dont. i very firmly believe in natural selection. there are without a doubt people too stupid to continue living and polluting the gene pool. allowing them to weed themselves out is a good thing.



Good point. From my perspective, I work more (right now) with kids than anything, and it's just breaks my heart when kids are the victims because of their parents stupidity. Add a kid into the situation, and it just seems to be so much worse than an adult doing stupid.


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## mikie (Sep 30, 2008)

sixmaybemore said:


> Don't we wish.



No!  Job security!


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## LucidResq (Oct 1, 2008)

KEVD18 said:


> i dont. i very firmly believe in natural selection. there are without a doubt people too stupid to continue living and polluting the gene pool. allowing them to weed themselves out is a good thing.



Then why are you in EMS? 90% of the purpose of this field is fighting natural selection.


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## Sasha (Oct 1, 2008)

LucidResq said:


> Then why are you in EMS? 90% of the purpose of this field is fighting natural selection.



Maybe hes in it for the 10%.

Or the pay.

BWAHAHAA I just choked on my gatorade.


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## Airwaygoddess (Oct 1, 2008)

Hmmmm, caring for the sick and injured and being the patient's advocate, I thought that is why we did this job.


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## mikie (Oct 1, 2008)

Airwaygoddess said:


> Hmmmm, caring for the sick and injured and being the patient's advocate, I thought that is why we did this job.



And the pay!  ^_^


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## rmellish (Oct 1, 2008)

And the great hours....and all the sleep


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## Sasha (Oct 1, 2008)

rmellish said:


> And the great hours....and all the sleep



And the excitement! You KNOW its exciting to get that stubbed toe call at 3am!


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## Ridryder911 (Oct 1, 2008)

Back to the OP. Although there are several hundreds of different seizure activity, if he did not loose consciousness during the "convulsions" and no postictal (relaxation phase) immediately afterwards, then I would assume that it was NOT a seizure activity. 

R/r911


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## VentMedic (Oct 1, 2008)

KEVD18 said:


> i dont. i very firmly believe in natural selection. there are without a doubt people too stupid to continue living and polluting the gene pool. allowing them to weed themselves out is a good thing.


 


sixmaybemore said:


> Good point. From my perspective, I work more (right now) with kids than anything, and it's just breaks my heart when kids are the victims because of their parents stupidity. Add a kid into the situation, and it just seems to be so much worse than an adult doing stupid.


 
Maybe we should stop putting effort into saving children who are 23 - 25 weeks gestation and those who have cardiac defects or the many other anomalies they can be born with. And yes, some can be attributed to the parents. If you can't fix stupid, this might be the next best solution. 

These kids are expensive and will probably require expensive medical care for the rest of their lives, where there too we have made great advances to see they live longer. Many 23 weeks babies do now grow up with few deficits but to get them through 3 months of NICU costs a fortune. Let's stick to 27 weeks and otherwise healthy babies being born like it used to be. If you can't fix stupid, this might be the next best solution. 

Since this country has its hangups about sex education in the schools or options made readily available, maybe we should just fund abortion clinics as an alternative. That too might keep the wrong people from having babies. 

Stop saving them while they are young or not yet born so they don't get the chance to grown up to be stupid adults. 

I hope no one takes what I just wrote as my opinion but rather crap I have heard from others during the 20+ years I have worked in the NICUs and PICUs. At least 2x/ year we must go to battle against remarks like that from people who try to take funding away from programs that benefit children.


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## ryanbg (Oct 1, 2008)

sixmaybemore said:


> Good point. From my perspective, I work more (right now) with kids than anything, and it's just breaks my heart when kids are the victims because of their parents stupidity. Add a kid into the situation, and it just seems to be so much worse than an adult doing stupid.



You would have a heart attack at my job then. I rescued a kid the other day, when I got him out and settled down, I asked him where his parents were. The kid says "Shopping at the MOA". (about 45 minutes away). This is a 7 year old kid.


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## sixmaybemore (Oct 2, 2008)

ryanbg said:


> You would have a heart attack at my job then. I rescued a kid the other day, when I got him out and settled down, I asked him where his parents were. The kid says "Shopping at the MOA". (about 45 minutes away). This is a 7 year old kid.



Oh, good grief. 



> I hope no one takes what I just wrote as my opinion but rather crap I have heard from others during the 20+ years I have worked in the NICUs and PICUs. At least 2x/ year we must go to battle against remarks like that from people who try to take funding away from programs that benefit children.



I'm in a mood tonight, so I"ll just say it. Sometimes, people really suck. As my three year old would say "you makin' me MAD!".


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## BruceD (Oct 4, 2008)

Could perhaps have been a myoclonic seizure.

(ref: http://www.epilepsy.com/epilepsy/seizure_myoclonic )

or more likely (due to age, reported length of seizure, and the fact the guy said nothing was wrong) a simple partial seizure (simple = no LOC, partial = ... partial body)

(ref: http://www.epilepsy.com/epilepsy/seizure_simplepartial )

Or .. maybe he was related to FAINTING GOATS!


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## volparamedic (Oct 8, 2008)

*Seizure vs panic*

Well, there are different types of seizures. Sudo-Seizure, Petite Mal and Grand Mal. The Grand mal's patients usually have a phase called postical. They're confuses and sometime extremely combative. The do not breath when they have these types of seizures and will have snoring respirations. Dilated pupils, tachy heart rates, very common to bite their tongue and sometimes incontient with BM or urine. It can be bad if the seizure last too long or have two or more with no complete recovery. Petite Mal they can space out or have a twitch and still talk. The good thing is they do not stop breathing. But that doesn't mean it's harmless. It may lead to more severe seizures.  Sudo-seizures are pshyological issues they can look like real seizures but then a just fine acutely. No postical phase. Don't be fooled though. Someone once filed a law suit because there was no care given for a sudo-seizure even though it wasn't life threatening and the other party one. The court saw SEIZURE in the word and didn't care about the rest of it. Always attempt to get an ambulance to check them out! And at least get an NPC signed AMA.

I actually had a healthy person have two seizures without a complete recovery time. The second seizure they had maxed out with 10mg valium and still seizing. They went to sinus tach, to sinus, to sinus brady, to junctional, to idioventricular, to asystole. Did 2 minutes of CPR and they came back at SVT 180. Come to find out...the body dumps epi and norepi into your system to protect it's self. This can cause cardiac dysrhythmia's even in health individuals.


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## dcap-btls (Nov 2, 2008)

Anyone think syncope?


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## FLAEMT22 (Nov 8, 2008)

Sounds like he was either shook up and had a pseudo-seizure. Something that presents just like a seizure with the same tonic clonic movements, but to a lesser degree. Or, maybe he had a focal seizure. But I have never heard of someone having a seizure while standing up, pretty sure they would lose all motor function.


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## mycrofft (Nov 8, 2008)

*We need a thread about seizures and some expert opinion.*

Any part of the brain can be injured and "seize" (or more historically "be seized"). People with real seizures can also do pseudoseizures. And there is the ever popular "psychomotor seizure", like the one which allegedly lasted three days to enable a defendant to illegally buy a gun, steal a car, rob a convenience clerk at gunpoint and pistol whip him to death, dispose of the gun, and flee the city.
Recovery from vasovagal is frequently accompanied by "funky chicken", also.


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## ryanbg (Nov 12, 2008)

KEVD18 said:


> go to medical school. seriously, thats the only way for you to be able to effectively diagnose and treat.
> 
> other than doing that, asses the patient according to your level of training, treat as appropriate, recommend that they be evaluated further by a physician, if they refuse document it and carry on with your day/life.
> 
> you cant save everyone. you cant fix stupid and you cant save the world. the very second you fully realize and accept that, 95% of the physical and emotional stress associated with emergency medicine flies away and never comes back.



I know this thread is old but... I wasn't insisting that I was going to treat the patient, I just was wondering if I should take the same precautions for a seizure as I would a situation like this that would happen to have lasted longer.


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## ryanbg (Nov 12, 2008)

FLAEMT22 said:


> Sounds like he was either shook up and had a pseudo-seizure. Something that presents just like a seizure with the same tonic clonic movements, but to a lesser degree. Or, maybe he had a focal seizure. But I have never heard of someone having a seizure while standing up, pretty sure they would lose all motor function.



He stood up after his episode had finished and he sort of snapped out of it. At this point I would assume he was just disoriented and panicking.


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## emt83 (Nov 20, 2008)

I am a seizure patient, and would like to explain to you how I feel after a seizure. I usually feel very tired and usually just want to rest. I have never had a seizure and then just popped right up like there was no problem that's interesting. I guess it depends on the patient. Who is to say that it wasn't an actual seizure though. Hope that helped answer your question.


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## MRE (Nov 21, 2008)

ryanbg said:


> I know this thread is old but... I wasn't insisting that I was going to treat the patient, I just was wondering if I should take the same precautions for a seizure as I would a situation like this that would happen to have lasted longer.



Just remember your lifeguard training.  Regardless of whether your patient is passive, semi passive, active or seizing in the water, if they are unable to keep their head above water and/or get to the side of the pool, you need to assist them with this.  After they come down the slide, and you determine that they have a problem, consider if you need to take spinal precautions (probably not, but depening on how they land, you might want to, just in case).  Assuming no spinal, do your 2 arm rear rescue and bring them to the side of the pool.  If they appear to be seizing, hold them at the side from behind (your arms under their armpits, holding the pool wall) until they stop or are calm enough to remove from the water.  Talk to them and telll them to remain calm and that they are safe.  If they are just panicking, they will more than likely climb out or attempt to climb out of the pool on their own.  Either way, treat the conditions you find once they are out (unconscious, not breathing, still seizing, etc) and call for an ambulance if necessary.  Have another guard or two assist you if possible especially if it appears they are panicking/behaving irrationally or seizing.

Cliff notes:

1. Get them out of the water safely
2. Treat conditions you find once on pool deck
3. Doesn't matter if they had a seisure or panicked, treatment is about the same.


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## csly27 (Nov 21, 2008)

Mabey he just wanted some attention, or to see if anyone was paying attention. I have seen many people do  stuff like that just for the attention when I was doing my externship for my Dr.


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