You are providing care to a patient who is having a seizure. which of the following is a priority?

Tonic-clonic seizures, formerly known as grand mal seizures, comprise two stages: a tonic phase and a clonic phase. These intense seizures can be frightening to experience or observe, as extreme muscle spasms may temporarily arrest breathing.

Inhaltsverzeichnis Show

What You Need to Know
Symptoms of a Tonic-Clonic (Grand Mal) Seizure
Tonic Activity
Clonic Activity
After the Seizure (Postictal Period)
What to Do If Someone Has a Tonic-Clonic (Grand Mal) Seizure
Diagnosis and Treatment of Tonic-Clonic (Grand Mal) Seizures
When to call an ambulance
Make a note of any useful information
Keeping a seizure diary
What is the priority for a person have a seizure?
What is the first action when a patient is having a seizure?
What are 4 priority medical interventions for seizure activity?
What is the treatment for a patient who is having a seizure?

What You Need to Know

Tonic-clonic seizures involve both tonic (stiffening) and clonic (twitching or jerking) phases of muscle activity.
Tonic-clonic seizures may start with a simple partial seizure or aura. The person may experience changes in sensation, mood or emotion leading up to the tonic-clonic seizure.
If you are with someone who has a tonic-clonic seizure:
1. Do not put anything in their mouth.
2. Turn them onto their side.
3. Make sure the area around their body is clear of objects that could hurt them.
4. Time the seizure.
Treatment for tonic-clonic seizures can involve medication, surgery, nerve stimulation, dietary therapy or a combination of these approaches.

Symptoms of a Tonic-Clonic (Grand Mal) Seizure

Aura

The seizure may start with a simple or complex partial seizure known as an aura. The person may experience abnormal sensations such as a particular smell, vertigo, nausea, or anxiety. If the person is familiar with having seizures, they may recognize the warning signs of a seizure about to begin.

Tonic Activity

When the tonic-clonic seizure begins, the person loses consciousness and may fall. Strong tonic spasms of the muscles can force air out of the lungs, resulting in a cry or moan, even though the person is not aware of their surroundings. There may be saliva or foam coming from the mouth. If the person inadvertently bites their tongue or cheek, blood may be visible in the saliva.

Stiffness of the chest muscles may impair breathing, the person’s face may look bluish or gray, and he or she may make gasping or gurgling sounds.

Clonic Activity

Jerking movements affect the face, arms and legs, becoming intense and rapid. After one to three minutes, the jerking movements slow down and the body relaxes, sometimes including the bowel or bladder. The person may let out a deep sigh and return to more normal breathing.

After the Seizure (Postictal Period)

After a seizure, the person may remain unconscious for several minutes as the brain recovers from the seizure activity. He or she may appear to be sleeping or snoring.

Gradually the person regains awareness and may feel confused, exhausted, physically sore, sad or embarrassed for a few hours. The person may not remember having a seizure, and may have other memory loss. Occasionally, people may have abnormal or combative behavior after a tonic-clonic seizure while the brain is recovering.

What to Do If Someone Has a Tonic-Clonic (Grand Mal) Seizure

Witnessing a person having a tonic-clonic seizure can be upsetting, but it’s important to remember that most seizures resolve on their own after one to three minutes. To offer assistance:

Protect the person from injury by helping them to the floor and clearing away furniture or other items. Do not attempt to hold the person still.
Do not put anything in the person’s mouth. It is physically impossible to swallow one’s tongue, and putting things in the mouth may lead to injury.
Time the seizure.
A seizure lasting more than 5 minutes is an emergency. Call 911.
Calm reassurance can be helpful to a person who is recovering from a seizure.

Diagnosis and Treatment of Tonic-Clonic (Grand Mal) Seizures

After a person’s first seizure, it is important to consult with a physician. Parents or family members who observe the seizure can note the details and help create a written report that the person can take to the doctor. A video recording of the event (if available) can also aid in diagnosis.

To ascertain the cause of the seizure, the doctor may prescribe magnetic resonance imaging (MRI) or other tests to look for scarred areas in the brain. Electroencephalography (EEG) can help distinguish seizure disorders from other conditions.

If the doctor determines the person has a seizure disorder such as epilepsy, an individualized approach to treatment can help manage it. A range of therapies, including anti-seizure medication, nerve stimulation, dietary therapy and surgical procedures can address the seizures and, in many cases, bring them under control.

If you see someone having a seizure or fit, there are some simple things you can do to help.

It might be scary to witness, but do not panic.

If you're with someone having a seizure:

only move them if they're in danger, such as near a busy road or hot cooker
cushion their head if they're on the ground
loosen any tight clothing around their neck, such as a collar or tie, to aid breathing
turn them on to their side after their convulsions stop – read more about the recovery position
stay with them and talk to them calmly until they recover
note the time the seizure starts and finishes

If the person is in a wheelchair, put the brakes on and leave any seatbelt or harness on. Support them gently and cushion their head, but do not try to move them.

Do not put anything in their mouth, including your fingers. They should not have any food or drink until they have fully recovered.

When to call an ambulance

Call 999 and ask for an ambulance if:

it's the first time someone has had a seizure
the seizure lasts longer than is usual for them
the seizure lasts more than 5 minutes, if you do not know how long their seizures usually last
the person does not regain full consciousness, or has several seizures without regaining consciousness
the person is seriously injured during the seizure

People with epilepsy do not always need an ambulance or to go to hospital every time they have a seizure.

They usually have a care plan agreed with doctors and their family or carers that says what to do when they have a seizure, such as giving emergency medicine. If you know what to do and have been trained then you can follow their care plan.

Some people with epilepsy wear a special bracelet or carry a card to let medical professionals and anyone witnessing a seizure know they have epilepsy.

Epilepsy Action has more information about seizures that last longer than 5 minutes.

Make a note of any useful information

If you see someone having a seizure, you may notice things that could be useful for the person or their doctor to know:

What were they doing before the seizure?
Did the person mention any unusual sensations, such as an odd smell or taste?
Did you notice any mood change, such as excitement, anxiety or anger?
What brought your attention to the seizure? Was it a noise, such as the person falling over, or body movements, such as their eyes rolling or head turning?
Did the seizure happen without warning?
Was there any loss of consciousness or altered awareness?
Did the person's colour change? For example, did they become pale, flushed or blue? If so, where – the face, lips or hands?
Did any parts of their body stiffen, jerk or twitch? If so, which parts?
Did the person's breathing change?
Did they perform any actions, such as mumble, wander about or fumble with clothing?
How long did the seizure last?
Did the person lose control of their bladder or bowel?
Did they bite their tongue?
How were they after the seizure?
Did they need to sleep? If so, for how long?

You can watch healthtalk.org videos of people talking about having epileptic seizures.

The Royal College of Paediatrics and Child Health (RCPCH) also has useful leaflets you can download about a first seizure without a fever in children and young people.

Keeping a seizure diary

If you have epilepsy, it can be helpful to record the details of your seizures in a diary.

Read more about seizure diaries and download one for free from:

Epilepsy Action: seizure diary
Epilepsy Society: seizure diaries

Page last reviewed: 15 December 2020
Next review due: 15 December 2023

What is the priority for a person have a seizure?

These are general steps to help someone who is having any type seizure: Stay with the person until the seizure ends and he or she is fully awake. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.

What is the first action when a patient is having a seizure?

STAY with the person and start timing the seizure. Remain calm – it will help others stay calm too. Talk calmly and reassuringly to the person during and after the seizure – it will help as they recover from the seizure. Check for medical ID.

What are 4 priority medical interventions for seizure activity?

Nursing interventions for a child with seizure disorder include the following:.

Prevent trauma/injury. ... .

Promote airway clearance. ... .

Improve self-esteem. ... .

Enforce education about the disease..

What is the treatment for a patient who is having a seizure?

Treatments include: medicines called anti-epileptic drugs (AEDs) surgery to remove a small part of the brain that's causing the seizures. a procedure to put a small electrical device inside the body that can help control seizures.