Exam 19: Seizures and Syncope

When an EMT performs the secondary assessment on a postictal seizure patient with a known history of seizures, what assessment finding would be of most concern?

How would you transport a seizure patient who may have a spinal-cord injury?

A 20-year-old patient is unresponsive with snoring respirations. She is in a public restroom with no family or friends with her. After addressing the airway, breathing, and circulation, you begin the secondary assessment. Which one of the following signs best indicates the patient experienced a seizure?

You are dispatched to a local mall and are met by bystanders who state that the patient was talking to a customer representative and "passed out." You find an alert and oriented 55-year-old female lying supine on the tile floor. The patient tells you that the back of her head is hurting. Which one of the following actions should you perform first?

The EMT would recognize that a 49-year-old male has suffered a primary seizure when his wife states:

You are caring for a postictal male patient with a known history of seizures. He is confused and cannot remember his 8-year-old son's name. His son tearfully asks you if his father will ever remember him. Your response would be:

Which one of the following signs and symptoms would be most helpful in determining that a patient had a syncopal episode rather than a seizure?

You are an EMT who finds an adult male on his living room floor. The scene size-up reveals a very cluttered home that smells of urine. On an end table you find a container of phenytoin (Dilantin) with the patient's name on it. When you pinch his shoulder, the patient responds by moaning and trying to remove your hand from his neck. Based on this information, you should suspect which one of the following conditions?

After a lengthy response, you arrive at the home of a 62-year-old female who is still seizing. Your immediate action would be to:

You are transporting a patient who has a history of simple partial seizures. During transport she experiences a simple partial seizure involving her right arm. Her pulse is 92, respirations 14 and adequate, blood pressure 168/88 mmHg, and SpO₂ at 98%. Your primary concern would be:

A young male with a seizure history is postictal in his bed. His airway is patent, breathing labored and forced, and radial pulse strong and fast. Vital signs are pulse 140, respirations 20, blood pressure 158/92 mmHg, and SpO₂ 96% on room air. At this time, what action would be most appropriate?

You have been called to a public bus station for a behavioral emergency. On scene you find a disheveled male in his forties sitting up against a wall. He is confused and incontinent. Bystanders state that he suddenly began to stumble around, shouting obscenities, and then fell to the ground spitting and shaking. From this description, the EMT should be suspicious of what condition?

A young boy tells you that his twin brother suffers from seizures and asks what he can do if he sees his brother convulsing. Your response would be:

You are by the side of an alert but confused 41-year-old woman who is diaphoretic and appears exhausted. She informs you that she has a history of seizures and just had a generalized seizure. Despite your urging, she refuses transport to the hospital. Your safest action would be to:

A patient who suffered an apparent syncopal episode refuses transport to the hospital. Prior to the patient signing a refusal, you should make which one of the following statements?

A 72-year-old male with a history of depressed thyroid function and a brain tumor is suffering a psychomotor seizure. As you enter the room, you find him to be standing up and walking in a circle. He is awake but does not respond to your questions. Family members state that he has had three similar episodes over the past six months, which his physician diagnosed as complex partial seizures. Vital signs are pulse 112, respirations 16, blood pressure 166/68, and SpO₂ at 98%. Which one of the following actions would be most appropriate in the care of this patient?

While placing a 52-year-old female on the stretcher, she begins to seize. Your immediate action would be to: