You’re taking care of a child with a high fever. Or you and your family have been walking for hours in the heat, bugging out of a bad situation. Maybe you’re trapped at home by a major ice storm and your partner slipped this morning and hit his head. There could be no obvious reason at all. Now someone you care about is staring heedlessly into space, or just dropped into a sudden faint, or is jerking around oblivious to your questions and concerns. What now? Preppers need to be able to recognize seizures and know what do to about them.
Note: I’m not a physician and this isn’t medical advice. I’m somebody who has spent a lot of time studying how bodies work and I’m sharing some information.
Why is this basic first aid information a prepping topic? Well, we’re preparing for emergencies, right? This kind of emergency is really common. It’ll get more common if health care is not available, given some of the reasons seizures occur.
What is a seizure?
To steal a line from Rush (the band), a seizure is “an electrical storm in your brain”. For whatever reason, a region of the brain has gotten into a wild, hyperactive firing pattern. Sometimes the wild activity stays in that region (focal seizure), and sometimes it spreads through many regions (generalized seizure)
See the storm starting halfway through this electrical recording of the brain? Thanks Der Lange for the image.
Most seizures last somewhere between 30 seconds and two minutes. They end on their own. Some of them are caused by known triggers (see below), but many times we don’t know why they start. You’ll here people say “epilepsy causes seizures” but that’s like saying birthdays cause old age. Whenever somebody has multiple seizures and we don’t know what caused them, the person is said to have epilepsy.
How do you know someone’s having a seizure?
This is harder than you might guess. Symptoms depend on what brain areas activate. All affected areas do a lot of whatever it is they normally do.
Motor control regions cause the most well-known symptoms; uncontrolled movements. These range from flickering eyelids to flailing arms. Inhibitory motor areas make one collapse like a rag doll. Sensory areas produce weird sensations; even hallucinations occasionally. Symptoms related to attention and consciousness are most common. Staring into space, not aware of what’s going on around you, is frequent.
The person having the seizure may feel it coming on. There’s often what’s called an ‘aura’. Weird sensations may arise. Colored halos around objects are often reported, as are strong odors. Emotions can pop up from nowhere – anything from joy to fear. Auras are really the seizure’s beginning stages, starting in a sensory area. Persons with epilepsy who’ve talked to me about it tend to have a similar aura each time.
What do you do for someone having a seizure?
Despite being weird and sometimes scary, the seizure isn’t that much of an immediate risk.
Summarizing from a bunch of first aid sources, the gist is:
- Leave them be physically, except to keep them from knocking into things or hitting their heads. You can put something soft under the head and move objects away. Don’t restrain the person.
- If you can catch them on the way down in a collapse, let them down gently.
- If they’re not unconscious but blank or confused, lead them away from danger. Stay calm and talk gently.
- IGNORE that bad old advice about putting something between their teeth!
- Make sure once the seizure’s over that they’re breathing ok. Especially after the big-movement seizure varieties, there may be a period of unconsciousness afterward. Clear the airway if they’re having any breathing trouble. (Here’s a one minute video from the Merck Manual on doing this.) Put them in the recovery position if they are still unconscious.
This is the recovery position. It helps keep the airway open in unconscious persons.**
What causes seizures?
Well, many times we don’t know. Sometimes we do.
Fevers cause seizures. This is common in children between six months and five years of age. This is because in kids, a fever of only 100.5 F (38 C) may trigger a seizure. In adults, only high fevers do this, above 104 F usually. The seizures itself aren’t dangerous. The source of the fever, often an infection, may be.
Uncontrolled diabetes can cause seizure. This is a stage right before coma, so do what you can to control the diabetes. I’ve been told you can pack sugar under the tongue, as low blood glucose is the most common trigger.
All other known causes are a lot less common, thankfully. Head injuries, especially those that cause internal bleeding, do it sometimes. Stroke can too, for the same reasons. Drugs or detoxing from drugs raises risk. That includes delerium tremens from alcohol withdrawal. Do you think we’ll be seeing any of that if the stores close?
5-10% of chronic alcohol users have some withdrawal when they suddenly stop. Seizures are one potential outcome.*
Avoiding recurrence of seizure
Seizures unnerve observers and disturb the person having them. They often leave a period of confusion and disorientation in their wake. Most often, the person who had the seizure won’t remember the event or the brief period preceding it.
Ultimately though, unless the person was driving at the moment, they’re not a big risk. The big question is, Why did the storm form in the brain? Is there something wrong there that can be fixed? If the cause is fever or diabetes or drug toxicity, the answers are pretty clear. Beyond that, in a prepper situation, there may be little to be done.
Epileptic seizures are more common in those with disturbed sleep, who are very stressed, or are exposed to very strong stimuli. A college friend of mine would be triggered by the flashing lights of video games, for example.
A strongly ketogenic diet (very low carbs) has worked with some epileptics, although it may be hard to sustain with long-term storage foods. Medical marijuana is prescribed in some cases. There are also some reports that melatonin supplements reduces seizure frequency. I’ll make another post on these remedies after more research.
References
Epileptic Society staff. 2018. First Aid Quick Guide. https://www.epilepsysociety.org.uk/seizure-first-aid#.XIzuRc9Kj-Y
Kneen, R., & Appleton, R. E. (2006). Alternative approaches to conventional antiepileptic drugs in the management of paediatric epilepsy. Archives of disease in childhood, 91(11), 936-41.
Mayo Clinic Staff. Seizures. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711. Accessed 3-16-19.
Rahman A, Paul M. Delirium Tremens (DT) [Updated 2018 Nov 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482134/
*MarcoMontero93 [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)]
**Rama [CC BY-SA 3.0 fr (https://creativecommons.org/licenses/by-sa/3.0/fr/deed.en)]
In my real life experience making sure the airway is open as soon as the seizure is over is very important. I have twice seen victims whose airway was completely blocked by the tongue to the extent it was necessary to clear it manually to restore breathing. Also be prepared to provide some emotional/psychological comfort to the victim afterwards.
Random5499,
You are very correct that securing a patent airway is always a concern in seizure patients. I’ve found that, barring a suspected cervical spine injury, the simple head tilt method generally clears the tongue from the airway. No need to stick your fingers in there, especially if they really aren’t fully done with the seizure. As a paramedic and police officer, I’ve treated quite a few seizure patients. Most of those who were epileptics and knew it, would come out of the postictal phase and say something like, “Oh, hell, I did it again, eh?”
Random, thanks for sharing your experience. When you say ‘clear it manually’, are you referring to a chin lift/head tilt, a jaw thrust, literally having to reach in there, or what?