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First aid for epilepsy in humans. What to do in case of an epileptic attack

First aid in case of an epileptic attack, as a rule, is provided to a person by those people who happened to be next to him at that moment. First of all, if you become a witness to an attack, you must call an ambulance so that the sick patient can receive the help of a qualified specialist. In addition, there are a number of simple rules that help to protect the patient during an attack before the ambulance arrives. You can turn to videos on the websites of professional medical communities, which in a popular way introduce how you can help a person with an epileptic seizure, whether an adult or a child.

An attack in an adult patient may begin with an “aura”, he anticipates loss of consciousness and convulsions and can inform others about this, the patient should lie on a bed or on the ground, away from traumatic objects, loosen his tie (if any).2

Immediately, without waiting for the arrival of a doctor, a child who has symptoms of “aura” should be placed on a flat surface (bed or floor), unbuttoned and loosened tight clothing, especially at the throat, to clear the airways. First aid for epilepsy in children, if an attack occurs outside the home, is to move the child to a safe place (away from water, traffic, sharp objects and corners), put something soft under his head, for example, a folded jacket . Remember that in the event of an attack, it is imperative to call an ambulance. It is necessary to protect the patient from injury, especially from head injury.6

If a convulsive attack in an adult or child occurs suddenly, and the patient does not anticipate it and cannot protect himself from injury, then first aid measures are taken after the onset of the attack. During an attack, the patient is not recommended to be transferred, except in cases where he may be in danger, for example, on the roadway, near the fire, on the stairs or in the water.

One of the standards in emergency care is to immediately put the victim in a comfortable position. With increased salivation and vomiting, the patient should be placed on his side so that he does not choke. This should be done gently, without using force. Before the arrival of doctors, you need to observe the patient. Do not try to keep the patient, limiting his movements. A dangerous complication of an attack – retraction of the tongue – occurs, as a rule, in the case of the position of the head face up with the head thrown back. Therefore, in no case should the position of throwing the head back be allowed! There is no need to try to open the patient’s mouth, even if the tongue is bitten, as this can lead to injury to the teeth, oral mucosa, upper and lower jaws, and the tongue itself. Among the urgent measures often mentioned is the need to lay an object between the teeth of the patient in order to prevent biting, which should never be done. Biting the tongue occurs at the very beginning of the attack. If the patient bit his tongue or cheek, then the injury has already occurred. Further attempts to open the mouth to avoid injury to the oral mucosa are useless and even dangerous.4

It is necessary to wait for the attack to end, being next to the patient and carefully observing his condition, in order to correctly and fully describe the manifestations of the attack to the doctor after the arrival of the ambulance. It is very important to note the time when the attack began, since the duration of the attack or series of attacks is very important for the attending physician. After an attack, as a rule, the patient feels weak, exhausted, or falls asleep. In this case, it is not necessary to disturb him in order to allow the nerve cells exhausted from the attack to recover. The standard of behavior of a person who happened to be close to the patient during an attack is to remain nearby and wait until the period of post-attack confusion (if any develops) ends and consciousness is fully restored. along with inappropriate behavior, aggressive actions towards others can also be noted. In such cases, it is important to remain calm and composed and try to provoke him to react as little as possible.3

When providing first aid for epilepsy in adults, do not pour water on the patient to “bring him to his senses”, do artificial respiration. It is also not recommended to try to wake the patient after an attack by shaking, tapping, inhaling pungent odors, or using any other methods. .

Seizures are often short-lived (several seconds or minutes) and end on their own. However, with prolonged seizures or seizures following one after another without recovery of consciousness, there is a threat of developing status epilepticus, and, in addition to providing emergency care, doctors should be immediately called for further hospitalization if necessary.7

It is important to remember the need to provide timely assistance for epilepsy and obtaining expert advice on how to act in an emergency, depending on the individual situation of the patient.

INTERNATIONAL LEAGUE OF ANTIEPILEPTIC RECOMMENDATIONS7

• 1. Voronkova K.V., Petrukhin A.S., Pylaeva O.A., Kholin A.A. Epilepsy is curable! Recommendations for patients and their relatives. Moscow, publishing house “Litterra” 2010. 176 p.
• 2. Karpova V.I., Krushinskaya N.S., Mukhin K.Yu. Epilepsy. Story. Diagnostics. Practice. Treatment. Tips for patients. Moscow, System Solutions, 2011. 224 p.
• 3. Mukhin K.Yu., Mironov M.B., Petrukhin A.S. epileptic syndromes. Diagnostics and therapy. Guide for doctors. Moscow, System Solutions, 2014. 376 p.
• 4. Devinsky O., Epilepsy. Patient and family guide. Demos Medical Publishing. 2008. 394 p.
• 5. Michalovska-Karlova E.P. journal Epilepsy.Medi.ru – No. 7, 2012. www.epilepsy.medi.ru Date of access – 11/28/2014.
• 6. Tikholaz T.V. journal Epilepsy.Medi.ru – No. 8, 2012 www.epilepsy.medi.ru Accessed 28.11.2014.
• 7. https://www.epilepsysociety.org.uk/first-aid#.WXrvZm997mF. Date of last access: 08.08.2017

SARU.VPA.19.11.2462

Colic – they pass! – articles from the specialists of the clinic “Mother and Child”

You can’t confuse anything with anything

A healthy child was discharged from the maternity hospital, he grows and pleases his loved ones. Yes, the baby sometimes cries a little, but what children do not cry! Moreover, over time, mom and dad get used to their new role and gradually understand what their baby needs. Yes, and the reasons for crying are usually simple: the child wants to sleep or, conversely, to communicate, he is cold or hot, in the end, he most often just needs to eat! Later, when colic begins, that crying of the first days and weeks of life will seem to parents only a slight irritation or whims. But mom and dad don’t know this yet and just rejoice at how their son or daughter is gaining weight and gaining strength. And suddenly out of the blue it starts! Usually in the afternoon, a child who was completely calm before that first frowns, wriggles, twists his mouth, grunts, then such a cry is heard that at the first moment especially tremulous parents clutch at their hearts. The baby presses the legs to the stomach, and often beats the air with his hands, his face turns red from crying, and his stomach tenses. And suddenly the child stops. Gone? No, almost immediately everything repeats again. And so at least half an hour in a row, and as a maximum – several hours a day. In the end, the child’s strength ends and he falls asleep in exhaustion. Exhausted parents, too. The next day everything starts all over again.

If you are very lucky, then such attacks will last only one or two times per evening for 30 minutes – 1 hour. On average, the attack lasts up to 3 hours. But there is a worse option: every day the strength, duration and frequency of screams will increase, until in the end the child starts screaming every two hours in the morning, and in the afternoon, and in the evening, and at night, of course. It will seem to parents that now this one is forever, but by 3 months babies are miraculously healed, only a few have colic that lasts up to 4-5 months (it’s good that they are already much less pronounced). That’s what they are, infantile colic! Well, from the point of view of doctors, colic is just paroxysmal pain in the abdomen, accompanied by severe anxiety of the child.

Many years ago it was noticed that there is a certain pattern in the manifestation of colic, the so-called “rule of three” :

• Colic often begins by three weeks of age – yes, this is almost always the case.
• Lasts an average of about three hours a day – unfortunately, this is only an average.
• Usually found in children of the first three months of life – fortunately, this is true.

There is also a positive moment in colic : usually the general condition of the child does not worsen with intestinal colic: the child has a good appetite, he gains weight properly, in the intervals between bouts of colic the baby is cheerful and looks as if nothing had happened. Against the backdrop of an endless ora, parents are already happy with every little thing. And since there are no other symptoms other than crying, then colic is not considered a disease. Doctors call them a functional disorder in the work of the gastrointestinal tract (this means that there is no structural disturbance in it, it’s just that the digestive system is not yet working quite correctly).

Have you read this far and become a little scary?

The best news: far from all children have colic! There are lucky ones who only shrug their shoulders in surprise when asked if their child had colic.

The reason is not established

There is another interesting feature of colic: it is difficult to determine exactly why colic occurs. There are many reasons for this, and each baby can have his own:

1. Enzymatic system of the gastrointestinal tract is not yet mature. Therefore, the food is not fully digested and too much gas is formed in the intestines, the gases stretch the walls of the intestine, hence the pain.
2. The intestinal microflora is not yet fully established and changes frequently, again leading to excess gas and pain.
3. The neuromuscular apparatus of the intestine is also not yet fully mature. As a result, intestinal motility and spasms increase.
4. The baby swallows too much air during feeding (it is incorrectly attached to the breast or sucks too greedily). Air stretches the walls of the intestines, which is also painful for many children.
5. Mom is breastfeeding and eating a lot of dairy products, and the baby is allergic to cow’s milk protein. As a result of this allergy, the intestinal wall is damaged. Secondary lactase deficiency occurs, the child lacks the enzyme lactase, which breaks down milk sugar. Sugar ferments in the intestines, there are more and more gases and, as a result, pain occurs.
6. The baby has an increased sensitivity of the intestinal wall to stretching. The child feels pain that another infant (or adult) will not pay attention to.
7. If the baby is bottle-fed, then the whole thing may be in the mixture. Most likely, it is not suitable for a child.

Well, if the cause of colic is some one and not very serious. For example, a baby swallows a lot of air during feeding. Then the colic will not be too pronounced. In addition, it is not difficult to eliminate this cause, you just need to adjust the feeding. As a rule, colic is quite tolerable as long as the child has functional immaturity of the gastrointestinal tract (for example, the microflora has not been established or there are few enzymes). The baby cries in the evening, even if for three hours, but 21 hours out of 24 he is quite calm. In the end, when every evening (or three or four times a week) the same scenario is repeated, you already get used to it.

But if there are several causes of colic at once or there is an allergy to cow’s milk protein with lactase deficiency, then parents will fully feel what it is like when a child throws a tantrum every two hours.

To make it easier for the pediatrician to figure out what is most likely the cause of colic, parents should tell him as much as possible about their child. To do this, will have to keep a diary of colic and nutrition of the baby . By the way, some mothers are so addicted to these records that they continue to keep them even when the colic has already passed (just in case). Well, then they get used to the fact that there are no more colic, and calm down.

What should be recorded in the food diary:

• When colic occurs: before, during or after feeding, if after feeding, after what time.
• How long does colic last.
• Is there any rhythm in colic, do they occur at the same time or at different times.
• When colic is most pronounced (morning, afternoon, evening).
• How a mother feeds a child – breastfeeding or formula. If breastfeeding, then how many milliliters the baby eats in one feeding. Breastfeeding by the hour or free.
• If formula is given, what kind, dosage and how often.
• What does a mother eat if she is breastfeeding.

What to do about it

Is it necessary to somehow examine a child with colic? Even if the doctor says that the baby has the most common colic, parents will still want to take a lot of tests and ultrasound of the abdominal cavity.

And it is clear that the more a child cries, the more mom and dad want to examine him .

Ultrasound usually shows that everything is in order with the structure of the child’s internal organs (immaturity and allergy are not visible on ultrasound). But parents even from this are already calmer. In coprology (fecal analysis), some changes are possible, and in the analysis of feces for carbohydrates (it confirms lactase deficiency), carbohydrates will be increased. Microbiological examination of feces (sowing) does not bring clarity to the picture of colic. The composition of the microflora, and so on, may not yet be fully established, and against the background of increased gas formation, in addition, it will be changed.

So what to do now? As already mentioned, colic disappears with age. Someone will say that you just need to be patient and wait. This, of course, is true, but when the baby cries and screams all the time, it affects the nervous system of everyone around. The situation in the house becomes nervous, the parents calm the baby with their last strength, and the mother also needs to feed the child, and walk with him, and cook food. Dad is also exhausted by endless screams and night vigils, and he is the breadwinner in the family, plus, if driving, he must concentrate on the road. In general, everyone needs rest, which means that colic needs to be dealt with somehow.

Let’s say right away that there is no 100% effective treatment for colic: although many ways have been invented to deal with them.

Someone helps one thing, someone else, you will have to try almost all methods:

Proper feeding . If the mother is breastfeeding on demand, then feeding should not become erratic, especially if colic is aggravated during meals or immediately after it. The baby should not swallow air during feeding, so you need to make sure that he completely captures the areola. If the baby is bottle-fed, then the nipple should be age-appropriate (the hole for milk in it should not be very large). You can use special anti-colic bottles – they prevent the swallowing of air during feeding. Before feeding the baby, you can put it on your stomach for 10-15 minutes, this stimulates the intestines. After feeding, the child must be held upright so that he burps the air. But for some reason, colic often occurs even if all these rules are observed.

Heat and massage . For some children, colic is relieved (or relieved) by putting something warm on their stomach or simply taking a warm bath. Someone helps just a diaper folded several times and ironed with an iron. But caring fathers wear someone for hours, attaching to their chest, or simply put the baby on their stomach, but, alas, there is no effect. The same thing happens if you give the baby a light massage of the abdomen in a clockwise direction: it will not help, you can only guess.

Mother’s food . Pediatricians often recommend that mom exclude any dairy and sour-milk products (milk, cheese, cottage cheese, yogurt, kefir, ice cream) from her diet. Under the ban are products that, even partially, contain milk: for example, cookies, pastries. Well, women are no strangers to diets, especially since with severe colic in the crumbs, the mother will already agree to everything. Usually after 7-10 days you can see if the diet helps or not. If there are results, then it is most likely that the child is allergic to cow’s milk protein and the mother will have to stay on a dairy-free diet for some more time.

Children’s herbal teas and products with chamomile, fennel (they relieve intestinal spasm and improve flatulence) – again, they have the most opposite result. But it is better not to give them yourself. Herbs can also be allergic, which will only increase colic. What remedy is better to give (or not to give anything at all), the pediatrician will decide.

Drugs that destroy the walls of the gas bubble . Here, as with other methods, the effect is often temporary and not 100%. After all, these funds only relieve the symptoms, and the cause of gas formation remains.

Enzymes for lactase deficiency . If it is confirmed, then enzymes (lactase) help well. The main thing is that the cause of colic is established correctly.

Motion sickness, wheelchairs and driving . They always rocked children, but it’s just necessary to pump, and not shake the child like a pear. Violent shaking can cause a concussion.

Unconventional products . It sounds strange, of course, but some parents claim that the sound of a vacuum cleaner or a hair dryer calms a screaming baby well.

Another way is to sleep in the fresh air. There are such amazing babies who, for some reason, calm down perfectly in the fresh air in the evening, but as soon as their mother tries to return home, they instantly wake up and raise a cry. As soon as evening colic begins, mothers grab the child, the stroller – and run into the street. And it’s not at all about riding in a stroller: the baby sleeps even if she just stands still. This is how mothers sit at the entrance until midnight.