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Actively Seizing
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Posted 4 months ago Great Case... 911 call of a 83 yr old male actively seizing Responded with ambulance to the residence to find the gentleman sitting at the kitchen table ( He was the party calling 911) was fully conscious and seizing Prior History of quadruple by pass in2004 , with no prior history ... B/P 137/94 temp 99.3 Pulse 80 and strong Pulsox 96 ... yet the patient was experiencing full seizures while conscious and was able to speak clearly and not lose train of thought whiel giving us a report of meals meds and date time and events leading to.... was an amazing ride to the hospital and waiting on Drs report as to cause and results ... patient is home now. with normal activities...Note: Patient only experienced clenched teeth every 55 to 65 seconds lasting for approx 5-6 seconds while speaking to us for the 22 min ambulance ride to the hospital.... Cant wait to find out the Drs report as they thought we were nuts til we came into the ER With the patient and witnessed the Seizures first hand..Drs Quote ... well Hmmmm... he's definately seizing... Patients retort... yah think? lmao |
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| Posted 4 months ago Hypocalcemic pt's can have tetany like spasms. They usually report pain with the spasms, especially while taking b/p. Didn't have pain with b/p did he? My extensive military knowledge is not limited to just being in line at the commissary, I also have extensive military knowledge of the 'Class Six'. |
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| Posted 4 months ago nope zero pain so that wasnt it... still guessing lol |
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| Posted 4 months ago How about Myoclonic seizures? I am a peds nurse so forgive me if my answer is way off the mark. "Don't worry that children never listen to you; worry that they are always watching you" - Robert Fulghum |
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| Posted 4 months ago Interesting post. Emergency intervention: ABC's, monitor respiratory status. Oxygen 100% by mask. Intubate if any chance of respiratory compromise. Establish EKG monitor. Establish two large bore IV lines. NEEDS CT scan of head to determine possible etiology (stroke). Toxicology screen for possible etiology. Pulse oximetry. Look at his meds. Diazepam IV to stop seizures. Do accucheck for blood sugar. This is only a beginning. You need to know his complete medical history, complete physical exam, family medical history, health habits and life style to efficaciously use medical reasoning to determine possible diagnoses and medical problems. For example, IF he has a history of alcohol or other substance abuse, his seizures may be related to the same. This is only conjectural.
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| Posted 4 months ago What are you calling "full seizure"? I'm just trying to paint a picture...is he just doing the boardlike, rigid body thing intermittently or what? Without seeing the pt, which would make a world of difference, I would lean towards something like Kitty spoke of. Maybe not cerebral in nature? Maybe focal tumor? The vast majority of seizures I've dealt with have been the usual brain-scrambling, full-body tetany, temporary airway issue, nobody's home seizures. Did they give him benzos when he arrived in the ed? |
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| Posted 4 months ago I'm curious, as to what the actual final diagnosis was. With a full blown grand mal, the brain is so full of 'electrical' charges, that the person ceaces to be conscious. He/she can't talk. Obviously something was going on that was seizure like. My extensive military knowledge is not limited to just being in line at the commissary, I also have extensive military knowledge of the 'Class Six'. |
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| Posted 4 months ago
Don't understand how the patient could be in full seizure and still be functional to call 911. Even with absence seizes there is generally no tremors only a momentary break in the thought process and a stare. I work on a neuro floor and in 3 years have seen many seizures but never where a patient could talk to you during the siezure. We even do 24 - 7 brain wave monioring of patients with a 24 hour visual and have never seen this. So give us the answer " What was determined wrong with the patient?" Our service to others is the rent we pay while here on earth!! |
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| Posted 4 months ago Im trying to speak with the attending about this matter as I was the respondibg EMT it is hard to catch the Dr with shift differentials I will get the answers I promise as i have not given up on the case.. Please be Patient I am doing what I can ...thanks |
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| Posted 4 months ago That's fine just keep us informed. With working with seizure patients I find this case very interesting. Just have never seen this and I would be interested in knowing if this is the first time the patient seized and if it is related to another disease process or if this person had seizures like this before. THANKS Our service to others is the rent we pay while here on earth!! |
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| Posted 4 months ago My bet is tetany, maybe related to some serious electrolyte imbalance. My extensive military knowledge is not limited to just being in line at the commissary, I also have extensive military knowledge of the 'Class Six'. |
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| Posted 4 months ago Could it be a lonely old man with attention seeking symptoms to go to the hospital for some TLC. Joni |
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| Posted about 1 month ago i work on a unit that hooks pts up to EEG 24/7 for a week straight. sometimes a pt can be having a full on seizure and the only person that knows it is the EEG tech watching the brain waves. so that person could have been having seizure activity, i've seen it happen. he probly knew it was coming on too hence the fact you found him on the phone calling for help. he may have been thru the scenario before. |
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| Posted about 1 month ago Epilepsy is often overlooked as a diagnosis because so many patients do not fit the bill for seizures. Some are diagnosed with Parkinson's due to signs/symptoms while being able to describe what is happening to them while trembling, as an example, while seizing. |
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| Posted about 1 month ago I will bet my next paycheck it was pseudoseizures......a psychological disorder realated to a conversion disorder. |
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| Posted about 1 month ago malfunctioning pacemaker, although there was no mention of him having one. Had a patient come to the OR, who had those symptoms and the cause was a malfunction in his AICD |
