Seizures: Questions Answered by an ER Registered Nurse

There have been many times that I have been in triage when a parent has brought in their child because they think that their child has had a seizure. The first thing I do is take the child's temperature and it is usually 105 degrees or higher. This is when Tylenol and Motrin are given, the child is stripped down and cool cloths are placed on the child because at this point we are trying to avoid another seizure.

I have come across this phenomenon that I cannot explain but some parents believe that Tylenol and Motrin cure fever. This is a misconception. Tylenol and Motrin CONTROL fever and need to be given in a timely manner so the fever doesn't get too high and cause a seizure. The source of the infection needs to be found and cured.

Now, a few words of seizures. If you are taking care of someone or come across someone having a seizure the only things you should do is call 911, roll them over to their side, and clear anything that is near them. DO NOT put anything in their mouth! That is a very common misconception. First, it is impossible for them to swallow their tongue, secondly they could bite you and cause another problem. The worst thing that can happen is that they bite themselves.

Once 911 arrives they will put in an IV and usually give a drug call Ativan if the patient is still having a seizure. If the patient is post-ictal (after the seizure), they will monitor their vital signs and get them to the ER as soon as possible.

If the seizure was due to fever the ONLY cure is to keep the fever at bay. Check the patient's fever every 4 hours or sooner if you feel necessary. The seizures usually happen at night and that is because everyone is asleep and no one is checking he temperature and it gets too high and a seizure commences. So the ideal thing to do is to set an alarm for every four hours so you can wake up and check the temperature and keep that fever down.

If this patient had no fever and no history of seizures, there will be blood work done and a CT (cat scan) of the head to try to find a cause. The ER doctor will put them on anti-seizure medication but will highly recommend that this patient see a neurologist.

If this patient has a history of seizures, the patient and/or family will be questioned i the patient is compliant with their medication. A CT will be done but the cure would be to take their medication. If the patient was taking their medication, the ER doctor will recommend that the patient see his/her neurologist to adjust medications.