Time for a new TV campaign – Epilepsy

We have all heard of Epilepsy and this is something we discuss on our First Aid courses. The topic itself is worthy of a full days’ training and there are several types of seizure people experience and indeed there are lots of individuals who will not always follow the typical patterns we see.

When I deliver training, or consult with staff who work with vulnerable people who are diagnosed with Epilepsy, they have care plans to follow which detail how their episodes present.

But I wonder how many of us would know how to manage a person having an epileptic seizure in public? And what if we make it worse

We can all have one episode but it doesn’t necessarily mean you get a diagnosis of Epilepsy. With that in mind let me share a story about my sister from many years ago. Whilst she was enjoying a day out in York with her partner, she began having convulsions, something she had never experienced before. These were full body in nature but short in time duration in this case. No wonder her partner called for paramedics as this would have been frightening. They arrived and gave her treatment. She has never had another episode since and yet the paramedics did explain to her it was probably epileptic in nature. A sudden burst of electrical activity in her brain functions.

Do you all remember the F.A.S.T TV campaigns?

Let me ask you all – How many of you recall F.A.S.T? Can you remember this from TV campaigns over the years? FACE – ARMS-SPEECH -TIME (to call 999). Yes, you’ve remembered, it’s about the serious condition known as Stroke. These TV campaigns ran for so long it seems to have worked. Literally every time I run a First Aid course and I mention the acronym F.A.S.T – most people in the room can recall which condition we are talking about and what is means.

It’s time for a new TV campaign about Epilepsy!

When delivering training on various topics to the Hospitality sector I often find myself chatting to staff and business owners about their customers’ behaviour. In Hospitality customers could have consumed alcohol which of course influences a person’s behaviour. However in any venue, or out in public, a person’s behaviour could seem a little odd to the untrained eye. To a Paramedic, Nurse or a First Aider this behaviour could be linked to a medical condition and it is this situation I want to talk about.

Could they be experiencing a seizure?
Would you think to approach the person to assist?

Let’s have a long running TV campaign just like Stroke, to educate the general public on this. It can be easy to make a person’s seizure worse through our well intentioned actions.

What should the general public look for?

Behaviours can be quite different when a Seizure starts but it could be – staring blankly for a period of time, repeat actions such as fidgeting or pacing around. Many times I have heard of a sudden laugh out loud moment for no apparent reason or seeming agitated and mumbling. These types of things shouldn’t last for too long.
If the seizure continues and the person looks like their body looks like it is tensing up, straining almost aggressive looking then it could be the Tonic phase beginning. Loudly crying out and looking like they are really struggling to control themselves. This will draw attention to other people about and it will likely seem very worrying at this point.
If the seizure continues they may enter Clonic phase and their whole body will convulse. This individual cannot control their movements and unless they are with their family or friends we do not know how long this will last. This will be frightening to see – ask anyone who works in Health and Social Care – they can all remember seeing their first Tonic Clonic Seizure !!

If a person enters a Tonic Clonic seizure as described briefly above, what can we do to help?

In the early stages when we are unsure just what is happening we might want to just quietly observe as long as they are in no immediate danger. Great if they are with their loved ones who can take care of them but you can always be ready to offer assistance if you think they need it. If not then be ready to support them e.g. the person walks out onto a busy road. It’s quite normal for a person’s awareness to drop out. If possible guide them with calm tones of voice, gentle movements from you as opposed to sudden jerked movements, try to de-stress the situation whilst observing their behaviour. I would suggest asking another person to try to assist you if they are willing. However, the situation could be, that they seem quite aggressive and you may not be able to help in the way you would like.
When a person starts to convulse they will not be aware of what they are doing. This is where we need to help. Once again if they are with their loved ones I’d hope they will know what to do but be ready to offer support just in case the family/friends are not able to handle what is happening (fortunately this is rarely the case as I hear during training sessions). More often than not you may be asked by the persons family to leave them alone as they know what to do and they would rather you leave. I’m not surprised, you are watching their loved one at the worst point in their lives and it is a very undignified situation. Losing bladder control or vomiting (or both).
If there is no one else about…….
1. Support to the floor as best you can
2. Allow the person to have their seizure but start to time it (this is very important). We need to know how long it will last. Move any moveable objects away so that they have freedom of movement. Any constraints on their movement will likely stress the body and in turn prolong it.
3. Call 999 – although it could have stopped by the time emergency services arrive but explain how you do not know this person and describe their behaviour and the length of time they have been convulsing. They will want to know if the seizure has been 5 minutes in which case they are a medical emergency. Sometimes individuals who go Tonic Clonic have Status Epilepticus- which means they will not come out of this state without assistance. This will kill them. Whilst delivering First Aid training myself the longest I have heard. convulsions lasting is 9 minutes. Fortunately they were accompanied by experienced Carers who knew what to do and were trained in giving out life saving medications.
4. It’s always best to have something soft at hand ready to gently place under their head as a person may aggressively bang their head against the floor.
5. Gently take off their spectacles (if wearing them) as they may cause injury.
6. ALWAYS protect the persons dignity. Cover the person with your jacket, ask a passer by if they can assist with this. You can ask people to line up to make a wall so that no one else can see.

Always my worry is getting it wrong. I still hear during training courses of holding people’s hands down during their seizure and thinking you must put something in their mouth to stop them swallowing their tongue.

DO NOT restrain their movements. It will create further strain on the body.
DO NOT put anything in their mouth. This will likely create a lockjaw action and create further strain around their mouth and face. It may even cause them a physical injury.
DO NOT put the person in the recovery position during convulsions. However IF, they appear to be vomiting as they lie on their back you may have no choice. Do so with minimum fuss as much as you can.

I really do think the well-intentioned public will not always be aware of the points raised above. I can see the person being gently lifted back off the floor and onto a seat. And even some members of the public thinking it is amusing and taking out their phones (even today during First Aid training I hear these stories) !!

We can do better!!

Reasons to call 999

If they are a stranger (you don’t know their patterns or duration)
If the seizure is 5 minutes or longer
If they appear to have wounded themselves such as head injury
If they go passive and another seizure starts back up within minutes

This is how you do it….

Allow me to share a rather heartwarming story from several ladies who attended a First Aid course and how they managed their friend who started to have a Tonic Clonic Seizure whilst out playing bingo. These ladies work with people who have Epilepsy.

It’s Saturday afternoon in a large Bingo Hall and several friends who all work together are hoping to win on the bingo. They intentionally sit on a large booth style seating area with 1 lady deliberately sat in the middle of their group.

During 1 of the games this lady starts to act a little odd (she stops knowing how to mark her card when her numbers are being called out) and all of her friends know what is happening. They carry on playing bingo as normal. Next she appears to lose consciousness (but doesn’t) and slowly slides down her seat. Whilst marking their bingo cards the 2 friends sat either side of her and discreetly aid her to the floor. She is now on the floor next to their legs convulsing. This lasts approx 2 minutes and they all carry on playing bingo whilst keeping an eye on her ) and the time).

As she comes round they retrieve from their bags various wipes etc. 1 of them has a hair brush. It’s now time for a break and as lots of people in the hall get up to go to the bar etc they aid her up from the floor and surround her and walk to the ladies’ room where she can now make herself look more presentable.

I’ll always remember that story and I’m sure we can all learn from it.

If this article has stirred your interest to become a First Aider, get in touch and we will be happy to answer any questions you have.

E: admin@duell-training.co.uk