Friday, February 08, 2008

What do you do when someone has seizures?

AROUND 40,000 Scots suffer from epilepsy – yet few people appear to know how to help someone who is suffering from a seizure, according to a survey conducted in schools and businesses.

Dave Crozier, an undergraduate student at Strathclyde University, has given presentations about epilepsy – and carried out his survey – at several businesses and schools, including Fife Constabulary and Park Mains High in Erskine, Renfrewshire.His results are from a small sample and his analysis is still in the early stages, but Crozier has found there are still critical misconceptions about epilepsy that could lead to serious mistakes in treating someone having a seizure.

And his findings back up a survey earlier this year of 4,605 university staff and students. It found a third of people would put something in the mouth of someone having a seizure to stop them swallowing their tongue, not realising it could block their airways. And 67 per cent said they would call an ambulance immediately, even though in a majority of cases a person can recover after a two– or three-minute seizure without need for hospital care.The authors of that study, a team from University College London, said it was "extremely worrying" such myths were still so widespread. Crozier has found similar problems in Scotland, despite improvements in education about basic care.

Questions in his survey ranged from "Would you let someone with epilepsy baby-sit your child?" to "Would you want your child or sibling to marry someone with epilepsy?" and "Can people with epilepsy join the police, fire service or armed services?".Many of those surveyed didn't realise that one in 130 Scots live with epilepsy and most also struggled to define the condition.Crozier, a community education student at Strathclyde University and who has epilepsy himself, says: "I liked my high school as a school but felt they had to do a lot more for me.

Most of my experience of epilepsy was outwith school, but a lot of seizures I took in school and I didn't think to tell people because my friends were my support group, not staff."I learned my own ways of coping and it was not by going to staff – I knew what the response would be. The approach was just, 'Oh let's just send him home'. To some I think I was more of an inconvenience."In Crozier's survey, one response to the definition of epilepsy said simply: "Sugar levels low causing seizures."Another pupil said if someone has a seizure: "Remove anything from a person's mouth and hold their tongue to stop them swallowing it or choking."

But another said: "Alert ambulance and stop another person from putting fingers in person's mouth."The answers from about 75 people surveyed by Crozier suggest a wide range of attitudes and myths about epilepsy.Perhaps the most surprising reaction at Crozier's presentations was when he concluded by revealing that he lives with the condition himself.Particularly at schools, he saw jaws drop and heard nervous laughs as they realised how hidden – yet common – the condition can be.

He says: "More first aid training is needed in schools and workplaces. A lot of people move someone having a seizure and if they had medical training, they would know how to handle individual situations."One organisation that has taken up the model of basic instruction on epilepsy care and symptoms is Fife Constabulary, which was named employer of the year by Epilepsy Scotland in 2006.Ross Bennet, a temporary chief inspector with the force, has had nocturnal epilepsy for ten years and helped Crozier conduct his survey with other officers.Bennet says: "In addition to normal first aid training, we tell officers how to recognise seizures and the signs of someone having had a seizure.

"It's definitely paying dividends. There's certainly less of a stigma than there was and epilepsy is more widely discussed by officers."Our officers are more confident now in dealing with situations. They know someone's hearing can be affected when coming out of a seizure – you might hear an officer speaking to you but nothing comes out of your mouth."If we came across someone who had some alcohol and was found on the ground and at first thought is just drunk and incapable, when you speak to the individual you realise early on that it was epilepsy."

Training has made a difference to the treatment people with epilepsy get from Fife Constabulary."Susan Douglas Scott, chief executive of Epilepsy Scotland, says: "Epilepsy is such a common condition, affecting 40,000 Scots. So it's sensible to know how to deal with seizures. Educating the public about first aid keeps people with epilepsy safe."They will be better treated and healthier thanks to proper care during a seizure. Informed people won't put an object into a person's mouth. They will wait five minutes before calling an ambulance."It's not rocket science but there's a real need to train the general public in epilepsy awareness."

EPILEPSY: WHAT TO DOPARTIAL seizures in particular need to be more widely understood, says Eileen McCubbin, a specialist epilepsy nurse at Ayrshire Central Hospital in Irvine.She says basic knowledge of how to treat someone with epilepsy is very important. There are so many different ways a seizure can manifest itself, and people can make a big difference by knowing the signs.One of the big misconceptions is that people will swallow their tongues if having a seizure
– and mistakes from people trying to help has resulted in broken teeth and bitten fingers.

"Sometimes putting them in the recovery position can be worse," she says. If someone is having a tonic-clonic seizure it's best not to move them unless they are in danger. Instead, cushion their head and wait until convulsions pass, then put them in the recovery position."We have partial seizures which can just look like tucking at clothes, swallowing repeatedly, wandering aimlessly or in circles," she adds. "A person is still in danger at that time. Keep talking to the person because that can sometimes help bring them around quicker."

McCubbin says well-meaning members of the public frequently call an ambulance when it isn't necessary for someone having a seizure.But she says: "Any seizure lasting longer than five minutes is definitely too long and you should call an ambulance."


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