Welcome to your next topic, Seizures
Seizure in children is one of the situations that both parents and health care professionals find particularly frightening. Kate Mackay is a Paediatric Emergency Medicine Consultant, working at Birmingham Children’s Hospital. Kate will take you through the following learning outcomes and teach you about the management of children having a seizure. For all those non-medics out there, parts of this topic are quite technical. You may find it easier to first download the Parent Information Leaflet attached to the bottom of this page. This is written in plain English and avoids technical jargon.
At the end of this module you should be able to:
Recognise that a child is having a seizure and the different types of seizure that children can have
- Understand when a seizure is an emergency
- Understand and be able to implement the APLS seizure algorithm
- Understand common and serious side effects of drugs given to stop seizures
- Understand the importance of accurate handover to ongoing medical practitioners
What is a seizure?
A seizure occurs when there is a sudden surge of electrical activity in the brain. It usually affects how a person appears or acts for a short time. The commonest type of seizure is called a tonic-clonic seizure and this is what most people think of when they think of a fit; the child loses consciousness, muscles stiffen, and then jerking movements of all limbs are seen. These types of seizure usually last only 1 to 3 minutes but it takes much longer for the child to return to normal (they are often sleepy after the fit).
There are different types of seizure (discussed later) but in all cases they become a medical emergency when:
- The active part of the seizure lasts 5 minutes or longer
- A child goes into a second seizure without recovering consciousness from the first one
If a child has a fit lasting longer than 30 minutes without medical intervention (maintaining airway, giving oxygen) there is a very real risk of damage to the brain.
It is important to recognise these medical emergencies, as early intervention with medication either by parents or medical professionals can affect the long outcomes for the child.
Seizures are not a disease in themselves
Instead, they are a symptom of many different disorders that can affect the brain. Some seizures can hardly be noticed, while others are totally disabling.
So how are seizures caused?
Seizures are caused by electrical activity created by complex chemical changes that occur in nerve cells of the brain. Usually there is a balance of cells that excite and those that can stop these messages. A seizure occurs when there is an imbalance between excitation and termination of activity within the brain and the consequential chemical changes that go with them. The chemical changes can lead to surges of electrical activity that cause seizures.
How do you recognise a seizure?
Take a look at the following simulation and use the questions posed to help you to learn a little more about seizures in children.
The 999 call
Let’s look at this situation together. A grandfather has called for an ambulance for his 7 year old grandson. He complains that he is fitting, he’s shaking all over and has wet himself. He is not sure if he is breathing normally.
Paramedics are dispatched. What do you consider en route? If this is a fit, is there a set plan to follow?
Have a think and share below.