Seizures

PArescueEMT

Forum Bartender
628
0
0
I just got off a call where my Pt. was having petit-mal seizures followed by vomitting. I have never seen that nor heard of that before. I was curious as to weather any of you have.

Pt 94y/o
P: 79
R:10
SpO2:95% r/a
B/P: 140/60
 

rescuecpt

Community Leader Emeritus
2,088
1
0
While typical petit mal seizures involve very little muscle activity (that's the one where people sort of space out)... atypical petit mal seizures involve more muscle activity - maybe her stomach muscles were spasming during or as a result of the seizure, causing the vomiting. Not sure though, could be totally unrelated.
 

MMiz

I put the M in EMTLife
Community Leader
5,203
236
63
I've never seen an active seizure in the field. I thought my first diabetic was seizing, but was promptly corrected by cop on scene (It was my first day of work, I swear! ALS was right behind me coming up the stairs too!)

Okay, now here is one for all you seasoned pros. It is my understanding that we are not to insert any "Bite stick" device into the pt's mouth when they're seizing. Why is it that we have them on all the rigs and jump kits then?
 

dgmedic

Forum Ride Along
8
0
0
pry things open with.....apply oral glucose to....itch your back in that just further than you can reach spot....throw at people....keep your cot from rolling away (place under the wheel)....split wood? haha .......

Really they do not have much functionality. Some states require it as part of the ambulance inventory to be considered as an "ambulance"

BUT...let's see how many funny uses we can come up with for the bite block

:)

-dg
 

ffemt8978

Forum Vice-Principal
Community Leader
9,116
189
63
Finger splint comes to mind.
 

cbdemt

Forum Lieutenant
145
0
0
...arts & craft supplies for the "slow days"

...drawing straws (or sticks in this case) for who has to ride in the back with the ETOH pt.
 

rescuecpt

Community Leader Emeritus
2,088
1
0
Originally posted by MMiz@Dec 1 2004, 09:19 PM
Why is it that we have them on all the rigs and jump kits then?
Yeah, we use them for finger splints and to apply oral glucose to someone's cheek if they don't want to suck on the tube. There's really no reason to put the bite stick in someone's mouth because if they're laying down (which they should be), their tongue will roll towards the back of their mouth and the probability that they will bite it is slim (but it still happens sometimes).
 
OP
P

PArescueEMT

Forum Bartender
628
0
0
PA reccomends that in the event of a grand-mal seizure, we should insert an Oral airway. but no bite stick.

We do have to have them on the truck to be an ambulance just to not use them..... :blink:
 

ffemt8978

Forum Vice-Principal
Community Leader
9,116
189
63
Originally posted by PArescueEMT@Dec 2 2004, 06:58 PM
PA reccomends that in the event of a grand-mal seizure, we should insert an Oral airway. but no bite stick.

We do have to have them on the truck to be an ambulance just to not use them..... :blink:
Assuming that they don't have a gag reflex and that you can pry open their mouth without putting your fingers into it.
 

TTLWHKR

Forum Deputy Chief
3,142
4
0
Originally posted by ffemt8978@Dec 2 2004, 10:03 PM

Assuming that they don't have a gag reflex and that you can pry open their mouth without putting your fingers into it.
We still carry one of those things that look like a giant cork screw... I believe they are called Jaw Breakers. I wonder when PA started saying that was a no-no? They taught us to wrap two tongue blades together with porus tape and stick it between a seizing persons teeth, but don't let go of it. :blink: oops. Guess I'll stop doing that if it's now considered an unacceptable practice.

:huh:
 

MMiz

I put the M in EMTLife
Community Leader
5,203
236
63
Originally posted by Blueeighty8@Dec 9 2004, 04:32 AM
We still carry one of those things that look like a giant cork screw... I believe they are called Jaw Breakers. I wonder when PA started saying that was a no-no? They taught us to wrap two tongue blades together with porus tape and stick it between a seizing persons teeth, but don't let go of it. :blink: oops. Guess I'll stop doing that if it's now considered an unacceptable practice.

:huh:
Blueeighty8,

First, it is my understanding that the screw-like devices are one of the worst inventions ever. I'm wondering if you ever used on in the field.

Again, I was told in my recent NR course that you never place anything in the person's mouth when seizing. Can you literally imagine properly holding your little device in there while they're seizing? I would think it presents a danger both you and them.

We'll see what others say.
 

TTLWHKR

Forum Deputy Chief
3,142
4
0
Well, I can adequetly immagine a person biting their tongue in half, aspirating on the blood and vomit to follow and then dying of pneumonia. Or I can immagine myself holding a 6" tape covered stick in someones teeth until such seizure subsides. I can immagine it b/c I have done it on more occasions that I can count.

I don't think it has ever hurt any of my patients, and has probably saved quite a few lives!

The JawBreaker... Have never used one, have never seen one used. The accounts of attendants of the past, in explaining how to use one sounded barbaric. We still have one in a box of old airways and dv masks in the ambulance. Eventually it will get put in the cabinet of our antique appliances.
 

rescuecpt

Community Leader Emeritus
2,088
1
0
Originally posted by Blueeighty8@Dec 10 2004, 09:46 AM
Well, I can adequetly immagine a person biting their tongue in half, aspirating on the blood and vomit to follow and then dying of pneumonia. Or I can immagine myself holding a 6" tape covered stick in someones teeth until such seizure subsides. I can immagine it b/c I have done it on more occasions that I can count.

I don't think it has ever hurt any of my patients, and has probably saved quite a few lives!

The JawBreaker... Have never used one, have never seen one used. The accounts of attendants of the past, in explaining how to use one sounded barbaric. We still have one in a box of old airways and dv masks in the ambulance. Eventually it will get put in the cabinet of our antique appliances.
If you've actually seen someone bite through their tongue, that's extremely rare. If the person is supine (as they should be), the tongue anatomically will roll back into their throat, or if it does stay in their mouth, shouldn't extend past their teeth because the muscles that allow this are voluntary not involuntary.

Is a bite stick your protocol? If it is, then that's fine. In most places, it's not. Make sure you're not jeopardizing your license. The Medical Directors *sometimes* know a thing or to and have a reason for their protocols.
 
OP
P

PArescueEMT

Forum Bartender
628
0
0
I had read once that the jawbreaker was one of those things that you use in the case of lockjaw to enable intubation. I would never use one of them. They have a tendency to break teeth, cut the gums and cause aspiration of blood. Even the EDs around here they don'y use them. you are the first that I know that has seen one.
 

TTLWHKR

Forum Deputy Chief
3,142
4
0
I have never seen a protocol that included a jaw breaker. I have seen thier purpose explained in the old EMT text books; I'm talking 70's now. Nothing recent on that. As attendants, we know to put the patient on their back; but the patient doesn't know this at the last second. Find them face down, on their side, wedged between a bed and the wall, sitting up after an MVA, etc.

If you can get that in thier teeth for just a few seconds, and suck some of that blood or vomit out, that is less of a chance they have of aspirating. If the seizure is on going, then you don't hold the stick in their the whole time obviously. Keep them as still as possible, and treat it chemically.
 

Top