Seizures are caused by abnormal discharging of a group or groups of neurons in the brain.<\/p>\n
The abnormal electrical discharge can be caused by head trauma,\u00a0meningitis, elevated core temperature, or physiological abnormalities.<\/p>\n
a. History<\/strong>. Ask these questions of or about the child:<\/p>\n (1) Has the child ever had a seizure before? If so, how often? Have the\u00a0seizures occurred when the child has had a fever?<\/p>\n (2) How many seizures has the child had?<\/p>\n (3) Does the child have a history of trauma? Diabetes? Headache? Stiff\u00a0neck?<\/p>\n (4) If possible, obtain a description of the seizure. Was the child’s whole\u00a0body affected or just one area of the body? Did the seizure start in one area of the body\u00a0and progress to other body areas? Did the eyes deviate to the left or to the right?<\/p>\n b. Physical Examination<\/strong>. Pay particular attention to these areas while you are\u00a0examining the child:<\/p>\n (1) Level of consciousness. Observe and note what the child can and\u00a0cannot do. Does the child respond in a logical manner to verbal stimuli? Does the child\u00a0just drift off to sleep abnormally? If he does this, can he be awakened easily? What\u00a0kind of stimuli is necessary to awaken a child who has drifted off to sleep? Can talking\u00a0in a normal voice wake him or must you scream to waken him? If nothing can waken\u00a0him, does he respond to physical stimuli by moving?<\/p>\n (2) Evidence of fever or dehydration. A child with fever will have hot,\u00a0flushed, dry skin; generally, poor skin turgor.<\/p>\n (3) Signs of injury. Check for signs of trauma to the head, tongue, or\u00a0anywhere else on the body.<\/p>\n (4) Neurological state. Perform a thorough neurological examination. This\u00a0examination will be repeated several times. The changes in the child’s condition and\u00a0the direction of those changes are very important. When you are doing the neurological\u00a0examination, be particularly attentive to these areas:<\/p>\n (a) Position of the child. In what position was he found? His position\u00a0can sometimes indicate certain injuries.<\/p>\n (b) State of consciousness. This is part of the neurological\u00a0examination and is mentioned in paragraph b(1) above.<\/p>\n (c) Speech. If the child is conscious, is his speech clear or garbled?\u00a0Even if his words are not in the proper order, is he still able to understand what is said\u00a0to him? Can he follow simple commands; for example, “Squeeze my hand.”<\/p>\n (d) Movement and sense of pain. When you are moving the child’s\u00a0extremities, does he know that you are moving his fingers or toes up or down? Does he\u00a0realize that you are pricking his toe with a pin? Does an unconscious child react to\u00a0painful stimuli; for example, pin pricks.<\/p>\n (e) Pupils of the eyes. Look at the child’s pupils to see if they are equal\u00a0in size. Are his pupils abnormally constricted or dilated?<\/p>\n (f) Eye movements. Can the child’s eyes follow your moving finger?<\/p>\n c. Treatment<\/strong>. The goal of treatment is to maintain the airway and prevent the\u00a0patient from injuring himself. To do this, proceed as follows:<\/p>\n (1) Sponge the child with lukewarm (tepid) water if he has a fever.<\/p>\n (2) Place the child on the floor away from objects that can cause injury. DO\u00a0NOT restrain him.<\/p>\n (3) Maintain the child’s airway.<\/p>\n (4) Administer oxygen to him and assist with ventilations, if necessary.<\/p>\n (5) Start an IV with D5\/W (5 percent dextrose solution in water) by micro drip\u00a0infusion (well secured), as ordered.<\/p>\n (6) Be prepared to give D\/50 (50 percent dextrose injection) in the dosage\u00a0of 1 ml\/kg.<\/p>\n (7) Once in the treatment facility, if the child’s seizures do not stop, prepare\u00a0to give diazepam (Valium\u00ae) in a dose of 0.3 mg\/kg. Give this medication in a slow IV\u00a0over a period of 1 to 3 minutes.<\/p>\n","protected":false},"excerpt":{"rendered":" Seizures are caused by abnormal discharging of a group or groups of neurons in the brain. The abnormal electrical discharge can be caused by head trauma,\u00a0meningitis, elevated core temperature, or physiological abnormalities. a. History. Ask these questions of or about the child: (1) Has the child ever had a seizure before? If so, how often? … Continue reading 3-15. SEIZURES<\/span>