Unconsciousness and Epilepsy

Unconsciousness is an interruption of normal brain activity. It can happen suddenly or gradually. Unconsciousness can be caused by a range of injuries and medical conditions, as well as by a number of different drugs. An unconscious person may still have some reactions to pain or to commands, or may have no reactions at all.

Whatever the cause or degree of unconsciousness, the immediate emergency treatment remains the same:

• Assess whether the person is unconscious by gently squeezing the shoulders and asking a question.
• Open the airway by lifting the chin, clearing the mouth, and tilting the head. Check the breathing and be prepared to resuscitate if necessary.
• If breathing, check for life-threatening conditions and then turn into the recovery position.
• Call for emergency help.

This may be all that you have time to do before emergency help arrives. However, if you have longer, there are some things that you can do to gather information that may help medical staff with their diagnosis and treatment.

ASSESS THE LEVEL OF RESPONSE. There is an agreed scale for assessing how responsive an injured or ill person is-- the Glasgow Coma Scale. A fully alert person will score 15 while somebody who is totally unresponsive will score 3 with several variations in between. You can help collect information to inform medical staff using some of the checks from this scale:

EYES. Do they:

• Open without you having to ask the person to open them?
• Open on command?
• Open if you cause the person pain (this is often done by pinching the earlobe)?
• Remain closed?

MOVEMENTS. Does the person:

• Understand and follow sensible instructions?
• Move only in response to pain?
• Not move at all?

SPEECH. Does the person:

• Answer questions sensibly?
• Answer questions in a confused way?
• Make sounds that cannot be understood?
• Make no noise?

Do the checks of eyes, movement, and speech every 10 minutes and record your answers.

FAINTING

A faint is a brief loss of consciousness. Shock is one of the potential causes of fainting but other causes include lack of food, a reaction to emotional news, or long periods of inactivity, for example, guardsmen standing for a long time in the summer.

To treat someone who has fainted, open the airway and check for breathing. If the person is breathing and there are no signs of injury, then the best treatment is to lie her on her back with her legs raised. This puts maximum oxygen back to the brain and speeds up recovery from a faint. If she has not begun to come around after 3 minutes, or if breathing becomes difficult, put her into the recovery position and call for help.

EXAMINING THE UNCONSCIOUS PERSON

Your initial check of the injured or ill person will be for life-threatening conditions, particularly serious bleeding. If you have more time while waiting for the ambulance, a more thorough check may show up less serious injuries or illness and potential clues to the cause of unconsciousness. This check should never be at the cost of monitoring and maintaining the airway or of keeping the injured person as still as possible. If doing a check of the body, it is sensible to do so in the presence of a third person.

Check the body from head to toe, looking for areas of bleeding, signs of broken bones or burns, or clues as to the cause of unconsciousness.

MONITORING AND RECORD BREATHING

Breathing is measured by counting the number of breaths in 1 minute (one breath being one rise and fall of the chest).

MONITOR AND RECORD PULSE RATE

Pulse rate is measured by counting the number of beats at the pulse at either the neck or the wrist for 1 minute. The easiest place to feel a pulse is in the carotid artery in the neck, though you can also check the wrist. Take recordings of breathing and pulse rate every 10 minutes and write down the results for the medical staff.

EPILEPSY
Epilepsy is a very common condition, best described as a rogue electrical discharge across the brain. As the body's functions are controlled be electrical impulses this discharge can lead to a number of physical reactions. Many things may start a seizure (fit): tiredness, stress, or flashing lights are common triggers.

MAJOR SEIZURE
This is what most people would recognize as epilepsy, and there are typically four stages:

1. Many people get a sense that a seizure is likely to occur.
2. The electrical impulses lead to a contraction in the muscles that causes the epilepsy sufferer to fall to the ground with a cry. This is known as the tonic phase. The victim's muscles may then go into spasm. This is known as the clonic stage. During this stage the victim will not be breathing.
3. When the convulsion is over, the victim will be in a state of unconsciousness.
4. On recovery from unconsciousness, the victim will be very sleepy and will want to rest for some time.

MINOR FITS. During a minor fit, somebody with epilepsy suffers a brief disturbance in the brain's normal activity, leading to a lack of awareness of his or her surroundings. To the observer it might seem like the person is daydreaming or has suddenly switched off.

     There is little for you to do other than to guide the person away from danger and reassure him when he returns to normal. If he is not aware of any similar episodes happening before, advise him to see a doctor.

TREATMENT FOR A MAJOR EPILEPTIC SEIZURE

1. During the seizure, do not try to restrain the person. The muscular contractions are so strong during a fit that holding a person down may lead to broken bones-- yours and his. Do not attempt to put anything in the mouth. Try to protect the victim-- move sharp objects out of the way, remove constrictions and, if possible, place a soft coat under the head.
2. Once the seizure has finished, check the victim's airway and breathing and be prepared to resuscitate in the unlikely event that this is necessary. Place the person in the recovery position.
3. When the victim comes round, offer reassurance. The person may have lost control of bowel or bladder function so cover him up and, when he is steady on his feet, help him to find somewhere to clean up. He is likely to be very tired so, if possible, find him somewhere to lie down and sleep. Most of all, ask him what he wants to do-- most epileptics manage the condition very well and will have their own coping strategies.

INFANTILE CONVULSIONS (CAUSED BY HEAT)

Babies and young children may have seizures induced by a high temperature. This may be the result of an infection or because they are overwrapped and in a warm environment. The signs and symptoms are similar to a major epileptic seizure.

TREATMENT. Make sure that the child is protected from hitting himself on a bed or cot-- do not attempt to restrain. Cool down by removing bedclothes and clothing where possible. Sponge the head and under the arms with tepid flannel or sponge, re-soaking it regularly. When the convulsion is finished, check ABC and take action as appropriate. In most cases, the child will want to sleep. Dress him in dry clothes and let him sleep. Call a doctor for advice.

WHEN TO CALL AN AMBULANCE. Generally, neither epilepsy nor infantile convulsion are medical emergencies. However, you should be prepared to call an ambulance if:

• The victim is injured during the seizure.
• The seizure lasts for longer than 3 minutes.
• There are repeated seizures in a short period of time.
• The victim does not regain consciousness.

If it is the first time seizure, advise the victim to call his doctor or take him to hospital.

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Frederick Luneta is a 24-year old guy and he is a Computer Engineering student and a young part time blogger. Currently lives in the Philippines. He knows a lot about computer.