While working on a CE lesson about seizures I was struck by the reality that EMS professionals very rarely see the patient seizing. We usually arrive when the patient is post-ictal. I have seen very few seizures in progress and most of the seizures I have seen were tonic-clonic and not absence seizures.
I visited YouTube, the number two internet search engine, and searched for absence seizures and found this video of a 5 year old. At the request of the video creator I am not able to embed the video so go to YouTube-Absence Seizure now and come right back.
If it weren’t for the annotations added to the video I am not sure I would have recognized the seizure signs. The signs are very subtle – swallowing, hair tugging, stopping purposeful activity, and not responding to the adult. Then the seizure ends and the child quickly resumes her previous activities.
Can you hear the concern in mom’s voice? I sure can. It made me think of all the times I have been called to assess a “sick” child and found a child that was anything but sick. On so many of those occasions mom apologizes or you can still hear the fear and worry in her voice, but there is nothing there to support the concern. This video is a good reminder that mom usually worries for a reason – something bad happened that was abnormal.
Could be a Lot Worse
A lot of what if’s arrive from this video … what if the child had been under water when she had the seizure or walking across the street or riding her bike or climbing the stairs. An absence seizure could potentially precipitate a traumatic injury.
This video also reminds me of how complex seizures are and relative to that complexity I really now. The Epilepsy Foundation has been distributing a free continuing education lesson on EMS Response to Patients with Seizures that has been getting a great response from EMS.
Using Videos for Simulation Education
At the NAEMSE Symposium educator Twink Dalton shared a great tip. She posts pictures on the screen above the high fidelity patient simulator to help put the EMS professionals into the environment, understand the mechanism, or see things on the patient’s skin that can’t be simulated. Use a video like this to have a class discussion about absence seizures, assessing a pediatric patient, or preface a pediatric patient simulation.
Another Absence Seizure Video
Also from YouTube. It is not normal for a toddler to lay still when a camera is in her face. As you watch this video look for subtle signs and then try to pinpoint the moment when the seizure breaks. I think it happens a few moments before the adult starts talking. What do you think?