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May 2009 | DentalProductsReport.com Exclusive
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Handling a seizure

Ten percent of Americans will experience a seizure in their lifetime. If it happened in your office, would you be ready?

By Thais Carter, Editor in Chief

According to the Epilepsy Foundation of America, epilepsy and seizures affect over 3 million Americans of all ages. Granted, thanks to medical history forms you are more or less aware of patients with special conditions, but also according to the EFA, approximately 200,000 new cases of seizures and epilepsy occur each year. Whether it’s a patient with a known condition or a surprise event, would you and your team know how to handle a patient experiencing a seizure in your office?

Roland Guy, RN, EMT-P, has been involved in emergency medical services for 25 years and is co-founder of Critical Care Solutions, a company that provides comprehensive medical training, supplies and equipment that enable dental offices to properly diagnosis and treat medical emergencies. In all his experience, he still believes that watching someone have a seizure is one of the scariest things he’s ever seen. “What you have to remember,” he said, “is that seizures are not life threatening and they are self-limiting in nature.” Another benefit? You’ll probably get a warning.

“Most patients experience an ‘aura’ anywhere from 10 seconds or a minute or so prior to the seizure itself,” Guy explains. “They will know it’s coming.”

How do I respond?
In terms of protocol for handling the situation, you should, of course, call 911 first. “You always want to do what’s right for the patient and getting paramedics there who can deliver care is number one,” Guy explains. And, while he points out that medically there is nothing you can do, the dental professional does have the critical role of ensuring that the patient does no harm to him or herself. “I recommend one person stand on each side of the chair to prevent the patient from flopping out and removing any stands or instruments—clearing things away from the patient,” Guy said. “After the seizure, the main thing to worry about are the ABCs.”

By ABCs, Guy is referring to airway, breathing and circulation. “Provide supplemental oxygen and ventillatory support if the patient is breathing. Keep the head tilted and chin lifted so that the tongue doesn’t block the airway,” he recommends. He went on to say that, “one thing a lot of dental offices have for oxygen is a protable nitrous set-up. The problem with this is that, in an emergency, it only covers the nose while most patients will be mouth breathing. They should be getting oxygen at 10 liters per minute.”

Additional advice: Be aware that patients may lapse into a post-ichtal state after the seixure, meaning they’ll go into a deep sleep that can last from a couple of minutes to a couple of hours. This is an especially important time for monitoring breathing. Second, since most patients will be aware that they suffer from seizures, they may want to turn down a hospital visit once they’re conscious. Guy suggests you do not let them leave. If they want to avoid the hospital, there is a consent form the EMT provides that they need to sign.

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