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Seizure Management Scenario (Responder)

Seizure Management Scenario (Responder)

You are called to a 36-year-old female experiencing a seizure. She has a known history of epilepsy. You are a Community First Responder (CFR) and have been asked to assist as the nearest ambulance is 20 minutes away.

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Question 1 of 15

1. Question

On arrival, the patient is lying on the floor having a seizure. She is jerking rhythmically in a repeated, synchronised manner. Her eyes are open but she is unresponsive. What type of seizure does this most likely represent?

Generalised tonic-clonic seizure
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Focal seizure
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Generalised non-motor seizure
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Generalised atonic seizure
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Question 2 of 15

2. Question

You place a pillow under her head to prevent injury. What else would be appropriate treatment at this stage?

High-flow O₂
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Gain relevant history from family
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Support the patient in their current position
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Move nearby furniture to reduce risk of trauma
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Push the patient into the recovery position and hold them there
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Attempt to administer epilepsy medication by crushing a tablet into water
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Question 3 of 15

3. Question

The seizure subsides quickly after your arrival. You try to obtain a history, but the patient is not responding appropriately. Is this normal after a seizure?

Yes
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No
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Question 4 of 15

4. Question

You record the following observations: HR 124, RR 22, SpO₂ 100% (on O₂), BP 135/82, Temp 36.8, BM 5.6, GCS 8 (E2 V2 M4). What phase of a seizure does this most likely represent?

Post-ictal phase
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Predictable phase
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Recovery phase
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Confusion phase
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Question 5 of 15

5. Question

Considering her age and gender, what additional question may be important in guiding management?

Are they pregnant?
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When were they diagnosed with epilepsy?
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Have they been compliant with their medication?
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When was their last GP check-up?
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Question 6 of 15

6. Question

The family confirm she is not pregnant. She has no significant medical history, is fit and well, and usually recovers after one or two seizures. Today they explain she has had 2 seizures lasting a total over 4 minutes without a full recovery in between.

The patient starts to have another seizure. How long must a seizure last, or a series of seizures without recovery in between last to be classed as convulsive status epilepticus (CSE)?

5 minutes
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3 minutes
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10 minutes
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1 minute
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Question 7 of 15

7. Question

Would this patient now be classed as status epilepticus?

True – she has not recovered between seizures
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False – because there has been a break between seizures
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Question 8 of 15

8. Question

You update control: the ambulance is 5 minutes away. After how long does the risk of long-term consequences significantly increase if seizures are not controlled?

30 minutes
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60 minutes
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5 minutes
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10 minutes
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Question 9 of 15

9. Question

What paperwork might this patient have that would be helpful in managing her seizures?

Individualised emergency care plan
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Prescription list
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DNAR
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ReSPECT form
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Question 10 of 15

10. Question

The care plan mentions that the family can administer buccal midazolam, but you are currently supporting the patient and trying to maintain a patent airway as best as possible. Can the family administer this even if the patient’s airway is at risk?

No
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Yes
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Question 11 of 15

11. Question

The family do not have buccal midazolam and you continue to manage the patient as best you can with positioning and O2. The ambulance crew arrives, what medication might they administer?

Diazepam
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Hydrocortisone
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Phenytoin
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Adrenaline
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Question 12 of 15

12. Question

Diazepam can be administered via IV and PR?

True
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False
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Question 13 of 15

13. Question

After PR diazepam, the seizure stops. The crew decide to transport the patient to hospital as her seizure pattern is unusual despite medication compliance. Which of the following are potential causes of seizures?

Infection
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Head injury
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Hypoglycaemia
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Stroke
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Alcohol intoxication
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Alcohol withdrawal
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Drug overdose
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Question 14 of 15

14. Question

During your assessment, what is one of the most important immediate risks to monitor in a patient experiencing a seizure?

Airway obstruction
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Hypothermia
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Hypotension
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Dehydration
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Question 15 of 15

15. Question

Which of the following should you avoid during an active seizure?

Placing anything in their mouth
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Restraining the patient in any way
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Using soft furnishings or clothing to protect them
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Timing the seizure
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