Sunday, June 9, 2013

Common Medical Misconceptions Pt 1

So I've been reading the Dresden Files, and I came across something that disappoints me enormously. The book further perpetuates a couple of myths that have caused me trouble in my profession as a school nurse. My school does have a couple of students who have frequent seizures, and so have the schools I was at before THS. I had one unfortunate case where I got there too late to prevent the aid from sticking something in her mouth and the girl wound up bleeding.

The myth: When someone is having a tonic-clonic seizure, you should hold them down and stick something in their mouth to keep them from swallowing their tongue.



Do not hold them down. You'll hurt them as they convulse against the restraints. You will accomplish nothing. You might even get yourself hurt in the bargain.

Do not put something between their teeth, ever. You can not swallow your intact tongue under any circumstances, including seizure. You may hurt their teeth, their cheeks, and your fingers trying to accomplish this, and if you're very unlucky, the clenching and unclenching of the person's jaws may result in the object going down their throat. This is not the desired effect.

On a side note, please don't give them food or water either, until the person is fully alert. Their swallowing functions may be impaired, resulting in aspiration.

Here's what you actually should do:

1. Cushion the person's head in some way to prevent injury. Don't hold it down. Just make sure that if it hits something, that something is soft.

2. Turn them on their side if possible. Seizures may result in vomiting - we don't want that in the person's lungs. That would be bad.

3. Time the seizure. If the person has a bracelet identifying them as epileptic, 911 may only be necessary if the seizure goes on longer than 5 minutes. Of course, if you don't know they have epilepsy, it might be a good idea to call anyway. When/if EMS arrives, they will want to know how long this has been going on.

4. When the person comes to, stay with them to provide reassurance and aid if necessary. Stay calm. Let them breathe. It doesn't help to panic and demand they talk to you and tell you what they need.

Now if you'll excuse me, I'm going to go grumble about priests getting people killed.

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