Doing the right thing at the right time

On a cold early winter morning, with lot of effort I got up wondering why did I sign up for a trial class of yoga. I was very ambitious the previous day and decided to go for the class by 6 AM. I have never been an early riser. I did manage to push myself and stepped out. I really enjoyed the one hour session.

As I was walking back, I started enjoying the winter sun. The road looked deserted. I noticed a boy standing in front of a house. I felt something suspicious about him, from far it felt weird and inappropriate. I walked cautiously and slowly.

As I came close to him I thought he was trying to call someone. He was making some hand movements and looked blank. I looked closer and then I realised! Gosh! he was having a seizure. He looked totally blank just staring and there were involuntary tonic movements of his left hand. It was a "complex partial seizure". I managed to slowly bring him to the footpath. By then few people gathered around. The minute one of them heard the word "fits" he disappeared only to reappear after few minutes with an iron rod. Thankfully within 2-3 minutes the seizure activity ended and the boy was following some basic commands though still confused and tired. We tried to search his pockets, there was no sign of a phone/wallet/Id card. His bags had few notebooks and test paper; which had his name and the phone number of his tutorial class. Somehow, we managed to connect and inform his parents.

I have seen many number of cases of seizures in my clinical practice almost always in the hospital setting. It was my first time on the street. It gave me a chance to observe how people respond in these kind of situations.

It was heart warming to see so many people who were willing to help, but were they doing the right things?

Even as the boy was still having seizures; somebody was trying to give him water, someone else tried to put sugar into his mouth. I already mentioned about the iron rod. I politely told them that I was a doctor and did not allow them to give anything orally.

Although everyone there was trying to help, they could have potentially caused more harm than good. We ourselves or one of our loved ones could be the victim or the first hand care giver, it is good to know some of the important things about seizures.

What is a seizure and what is epilepsy?

Seizures are abnormal movements or behaviour due to unusual activity in the brain, seizures are symptom of epilepsy.

Epilepsy is a group of related disorders characterised by tendency to recurrent seizures due to some underlying cause.

Why should I know about it ?

• One in 20 will have epileptic seizure at some point in their lives.

• One in 100-200 people in general population has epilepsy at any given time.

• About 50-70% patients will develop epilepsy(have their first seizure) before the age of 18 years.

Considering it is quite common, it is good to learn how to identify and give the right care at the right time.

How to identify seizures?

GENERALISED SEIZURES - The most common and dramatic. In this type of seizure, the patient loses consciousness and usually collapses. The loss of consciousness is followed by generalized body stiffening (called the "tonic" phase of the seizure) for 30 to 60 seconds, then by violent jerking (the "clonic" phase) for 30 to 60 seconds, after which the patient goes into a deep sleep (the "postictal" or after-seizure phase). During these type of seizures, injuries and accidents may occur.

ABSENCE SEIZURES - commonly seen in children, cause a short loss of consciousness (just a few seconds) with few or no symptoms. The patient, most often a child, typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. 

COMPLEX PARTIAL SEIZURES - In this type of seizures, person's behaviour may seem inappropriate for example lip-smacking, clutching at clothes, wandering purposelessly with a glazed expression. They are in a temporary state of altered consciousness.

There are many other types but I have described only the common ones.

What to DO when someone is having seizures?

• Stay calm
• Prevent the patient from injuring himself.
• Block the fall of the person onto the ground.
• Loosen their belt, neck tie, or other tight clothing, remove the spectacles.
• Cushion their head.
• Clear away any sharp or hard objects.
• When the seizure is over, turn them on their side to prevent choking.
• After the seizures stops turn the patient to a side and wipe the froth from his mouth.

What NOT TO DO when someone is having a seizure?

• Do not panic and do not be afraid!!!
• Do not insert spoon or any such articles into the mouth.
• Do not restrict convulsive movements.
• Do not try to insert a gag in the mouth it may cause difficulty in breathing and also hurt the helpers fingers.
• Do not crowd around the patient.
• Do not give water or any other liquid till he is fully conscious.
• Do not try and physically hold the person, this may injure both the person and the helper.
• Do not give any sharp or metal objects to them, they can injure themselves.

This particular incident taught me few important but often overlooked things, medical emergencies can happen to anyone at any time, it is a good idea to carry some ID card with at-least one or two emergency contact numbers written on it. As a doctor, the most important thing I learnt was that I need to educate my patients whenever possible on basic first aid.

We live in a very cynical and very indifferent society, nobody wants to take first step to help, but it can mean life or death to the other person. Please do not hesitate to take that first step.

I haven't made up my mind on joining the yoga class, Lazy me! Very very glad that I was there at the right place at the right time.