Fits / Convulsions

8/7/2019 Fits / Convulsions

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FITTING/CONVULSIONS

Fitts/convulsions means contractions of the muscles

An Abnormal Firing of brain cells ,usually resulting intwitching movements.also known as convulsions,epilepsy or seizurez( sudden attack)


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In a normal brain, thereare millions of specializednerve cells, called neurons,that transmit electricalimpulses. These impulsescommunicate with otherareas of the brain and

serve in the everydayfunctions.


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AB NORMA L FIRING OFB RA IN CELLS

when the normal electricalbalance in the brain is lost.The brain's nerve cells misfire

They either fire when theyshouldn't or don't fire whenthey should.

The result is a sudden brief , uncontrolled burst of abnormalelectrical activity in the brain

When these impulses misfire , seizure occurs.


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CA USES OF CONVULSIONS/FITTING

Cardiac arrestDiabetes

DrugEclampsiaEpilepsy(unknown)Fever( In children)Hypoxia(inadequate oxygen)

Meningitus(Infection around the brain)


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KEY QUESTIONS

Q1. H as s/he had more than one fit in a row?

CONTINUOUS FITTING

A fit in an unconscious patient that is still in progress at the endof the interrogation and after a physical verification by thecaller.(EMD must stay on the line to check)

MULTIPLE FITTING

The occurance of more than one fit in a patient whoremains unconscious or not alert between episodes

Localised twitching the part of the body such as thehand ,arm ,leg ,or face ,in a concious patient.m

Focal FITTING


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KEY QUESTIONS

Q2 .Female(12-50) is she pregnanat?

Q3 .Is s/he diabetic?

C 1 FOCA L fit (not alert) 12-c-12 Pregnancy 12-c-23 Diabetic 12-c-3


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Q4 Is s/he an epileptic or ever had a fit before?

EPILEPSY

IT is a common chronic neurological disorder characterized by seizures .It is a disorder of the nervous system

RECURRENT FITTING

Epileptics may have more than one fit in a day.these are considered as arecurrent fits if the patient is able to regain consciousness betweenepisodes.

KEY QUESTIONS

FEBRILE FIT

Febrile fits occurs in 3 to 5 % of all children between 6 months and 5years of age as the result of fever


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Q5 . (NON FOCAL) h as t he twittc h ing stopp ed y e t? (NO) ................................................................................... 12D2

a. (YES) Okay is s/ he br e at h ing at t he mom e nt? (Go an d c he ck an d t e ll m e w h at you fin d )..........................?

KEY QUESTIONS

Q6 .(FOCAL) Is s/ he compl e t e ly Al e rt(r e spon d ing Appropriat e ly)a. (NO) Okay is s/ he br e at h ing at t he mom e nt?

(Go an d c he ck an d t e ll m e w h at you fin d )...........................?

? (Br e at h ing) okay , I want you to tell me every time s/he tak e s a br e at h, starting now

. >10 s e c int e rval=agonal/in e ff e ctiv e


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TYPES OF FITTING

Absence (petit -mal) fitts

Petit mal is French word means "little illness.

Atonic (drop attacks)

Atonic means "without tone"

Myoclonic Seizures(brief bilateral twitches)

Myo" means muscle and "clonic" means rapidly twitchingof a muscle.

Tonic-clonic Seizures


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video


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DETERMIN AN AT DESC RIP TION

LEVELS # DETERMINA

NA

T DESCRIPTION E CODESD 1 Not breathing(after key question) 12-D-1

2 CONTINUOUS OR MULTIPLE fitting 12-D-23 A GONA L/INEFFECTINGB REATHING 12-D-34 Effective breathing not verified > 35 12-D-4

C 1 FOCA L fit (not alert) 12-C-12 Pregnancy 12-C-23 Diabetic 12-C-3

B 1 Effective breathing not verified


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RULES

A fit in a person 35 is considered a cardiac arrest untileffective breathing is physically verified by the caller.

Check ABCs very carefully before initiating CPR after a fit.

When the initial Chief Complaint appears to be fitting, go toProtocol 12 regardless of consciousness and breathing status.

D o not attempt to reduce fever in febrile fitting patient.


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Ax ioms

Fitting-like activity can be initial symptom of cardiac arrest .

All actively fitting patients appear to have abnormal or absentbreathing.

A fitting patient with an unknown history of fits has most likely hadfits before

Tonic-clonic (grand mal) fits generally last about 60 seconds .

Some patients experience a premonition or sensation (aura) prior to having a fit. An aura may involve strange sights , sounds , smells , or tastes. These patients may call for an ambulance before actuallyhaving a fit .


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POST DISPATCH INSTRUCTION

a. I am organizing help for you nowstay online and i will tell you exactly what to do next

b. (not breathing after KQ S ) go for cpr

1.dont do resuscitation.2.dont hold her/him down or force anything into her/his mouth3.move dangerous objects away from her/him

c. If s/he is still fitting(or if s/he start a fit again to fit again)


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d. W hen s/he stop fitting (lay her/him down) and make sure s/heis breathing.

e.Turn her/him gently on her/his side when the fitting stops.

f.W hen s/he wakes up ,reassure her/him and tell her/him not toget up or walk around

g.(not fitting) if s/he start to fit again ,tell me imediately.

POST DISPATCH INSTRUCTION

S tay on line with caller untill the patient starts to wake up.


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24%

25%

51%

Gender Wise Report

Male Female C hildren


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0

5 0

100

1 5 0

2 00

25 0

300

3 5 0

DELTA C HARLIE BRAVO ALP HA ALP HA

311

93

4 0

13 4

LEVEL WISE REPORT


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0

5 0

1 00

15 0

63

1 03 99

7667

5 3 55

22 2812

STATION WISE REPORT


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4 0 1

1

0 1 3 10

50

1 00

1 50

200

250

300

350

4 00

4 50

Hosp - Hosp Home -Hosp

Hosp -Home

Rodeside -Hosp

Alreadytransfer/Exp

First aid

ORIGIN WISE REPORT


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EXPERIENCE

EC NO:115413DATE: 7 th march 2011TIME: 12:25GENDER:MALE

AGE:60 YEAR SCODE:12D2FROM :LANDHITO:JPMCEMD:NA S IRARE S : 9 MIN

EC NO 115302DATE: 7 th march 2011TIME:6:02GENDER:FEMALE

AGE:42 YEAR SCODE: 12D2FROM:FJCTO: S IUTEMD:HERALDRE S : 10 MIN

EC NO 79798DATE:26 thOCT2010TIME:9:06GENDER:MALE

AGE:55YEAR SCODE: 12D2FROM :LANDHITO: S IUTEMD: S ADIARE S : 13 MIN


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SEIZURES FA CTS

S eizures is not a reason of death

As we have two death records1.EC: 84805 DATE: 13 TH NOV 2010

AGE:2 YEAR S GENDER:CHILD

2.EC: 97718 DATE: 04 TH JAN 2011AGE:65YEAR S GENDER: FEMALE


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200 ,000 new cases of epilepsy are diagnosed each year.

SEIZURES FA CTS

Incidence is highest under the age of 2 and over 65.

45 ,000 children under the age of 15 develop epilepsy each year.

Males are slightly more likely to develop epilepsy than females.

In a series of more than 2000 cases found that 57% of them weremale and 43% were females.


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Documents

Fits / Convulsions