加利福尼亚大学旧金山分校讲座癫痫与发作病人的评估解读.pdf

Module 4 The evaluation of a patient with a first-time seizure First-aid for a Seizing Patient 1. Stay calm and make sure someone is in charge. 2. Make sure the patient is lying down in a safe location. Clear all obstacles away, and place something soft under the patients head. 3. Quickly assess ABCs (airway, breathing, circulation). Patients typically do not appear to be breathing well during a seizure, but this should correct promptly once the seizure has ended. If not, administer CPR or prepare for intubation immediately. 4. Roll the patient to his or her side. Rotate head far enough to ensure the saliva, etc., is cleared. 5. Do not attempt to place anything (e.g., tongue blade, spoon) into the patients mouth during the seizure. First-aid for a Seizing Patient (con’t) 6. Look for MedAlert tags to determine whether the patient has a known history of epilepsy, prescribed medications, or other medical problems. 7. If outside of the hospital, should you call 911? Do this if: • it appears to be a first-time seizure • the seizure lasts for more than 4-5 minutes • there is any indication of other acute medical problems (e.g., trauma, metabolic disturbance Differential diagnosis of a seizure • Main issue is seizure versus syncope • Other possibilities: psychogenic non-epileptic event, sleep disorder, migraine, TIA Syncope Generalized Seizure Onset Stereotypic Highly variable, but (palpitations, light- consistent for the pt. headedness, “seeing (e.g. no warning; déjà stars”, diaphoresis, vu; “gastric rising”;