Exam 19: Seizures and Syncope

While transporting a 41-year-old woman who is not feeling well, she begins to seize. She has no history of seizures and the seizure lasts approximately 90 seconds. After 30 seconds of being postictal and unresponsive, the woman suddenly seizes again for the remainder of the 12-minute transport. The EMT should recognize which one of the following conditions?

A man comes into your station and tells you that he was just diagnosed by his physician as having a syncopal episode the previous week. More specifically, he asks you to explain why he fainted. Which one of the statements that follow would be your best response?

As you approach a female patient, she appears unresponsive with her arms and legs jerking violently. On the prehospital care report, you would document that the patient was found in what phase of a generalized seizure?

You are to transport a 46-year-old male who has had multiple seizures throughout the morning. Currently, he is on your stretcher and is postictal. He has a history of seizures for which he takes anticonvulsant medications. He also suffers from diabetes and kidney failure. Of the equipment listed below, which one is most essential to have ready during transport of this patient?

You have been called for a 47-year-old female who has "passed out." As you enter the patient's apartment, you find her supine on the living room floor with a cool wash cloth on her forehead. She states that she was standing and talking on the telephone when everything went dark. When she came to, she was on the floor. What should be your first action?

Which one of the following statements made by a patient who experienced a syncopal episode should concern the EMT most?

Regarding a generalized tonic-clonic (grand mal) seizure, which statement is true regarding the different stages?

A postictal patient is awake but has trouble answering your questions correctly. Given this presentation, the EMT would recognize that:

Which type of seizure occurs in children and is caused by a fever?

Which one of the following statements about seizures is true?

The initial part of a generalized seizure experienced by some patients is called the:

A female patient with a history of seizures has suffered a seizure in a public area and is now refusing further assessment and transport. As you leave, a witness to the entire event tells you that he thinks the patient is "crazy in the head" because right before she seized, she looked up toward the ceiling and kept repeating, "Do you see the birds?" As a knowledgeable EMT, you should recognize that the bystander is describing what condition?

A 36-year-old diabetic male with hypertension has suffered a secondary seizure. The patient responds to verbal stimuli with garbled speech and his airway, breathing, and circulation are intact. Vital signs are: pulse 128, respirations 20 and adequate, blood pressure 158/96 mmHg, and SpO₂ 97% on room air. At this time, it is important that the EMT:

You find a patient, who seized for approximately 2 minutes, supine on the kitchen floor. He responds to painful stimuli and has snoring respirations. Emergency Medical Responders are holding manual in-line spinal stabilization and report the following vital signs: heart rate is 124 beats per minute, and his pulse oximetry is 89% on room air. He has cool and clammy skin. Which one of the following should you do first?

As a general rule, a postictal patient should be placed on the stretcher and transported in what position?

When performing the secondary assessment on a confused patient, which one of the following signs would be most suggestive of a seizure?

You are called to a residence to assess a child. The panicked parents state that their 3-year-old son was playing with his brother when he suddenly "blanked out" and would not respond to them for several seconds. When asked, they deny any convulsing-like movement as well as a history of medical problems. Based on this description, you would be suspicious of what type of seizure?

Which one of the following patients should be classified as suffering from status epilepticus?

You have been called for a 71-year-old male with seizure activity. At the patient's side, you find him lying motionless on the floor of his bedroom with a family member performing chest compression only CPR. In this situation, your immediate action would be to:

A patient has been actively seizing for 17 minutes. He is cyanotic with shallow respirations. What immediate care should you provide to this patient?