Medical emergencies involving seizures seem to be a common cause for the dispatch of Emergency Medical Services and despite local treatment protocols, First Responders, Emergency Medical Technicians, and Paramedics remember the basics of their training. Aside from crew safety, airway, breathing, and circulation are the first priorities of any Paramedic and Emergency Medical Technician. Once airway, breathing, and circulation are under control, the next step is to fully assess the patient and administer medications per local protocol in attempt to stop the seizure.
However, what if the medical emergency involving seizures is not a typical presentation EMS responders are used to? What if the medications that are being administered are not working? Could there be another unknown cause? In other words, Dravet Syndrome is a rare genetic disorder affecting one in every 30,000 births.
Dravet Syndrome is also known as severe myoclonic epilepsy of infancy. The Dravet Syndrome Foundation defines it as "a progressive disorder characterized by multiple seizure types, often including life-threatening status epilepticus (prolonged seizures that require emergency care.)"
Various conditions associated with Dravet Syndrome includes "behavioral and developmental delays, movement and balance issues, orthopedic conditions, delayed language and speech issues, growth and nutrition issues, sleeping difficulties, chronic infections, sensory integration disorders, disruptions of the autonomic nervous system (which regulates things such as body temperature and sweating)" (Dravet Syndrome Foundation).
So what does this mean for emergency medical responders and bystanders? Ask someone to call 911 while you stay with the patient. Airway, breathing and circulation are all imperative to life sustainability. According to the American Heart Association 2010 CPR Guidelines, the first step an EMS responder or bystander should do is open the patient's airway and check for breathing. If patient is breathing, make sure they are breathing adequately by looking at their chest for a rise and fall motion.
In an event where the patient is not breathing, check for a carotid pulse. If a pulse is present, pinch patient's nose and begin rescue breathing with a mask or a barrier device with one slow breath every three seconds for pediatrics while looking for that chest rise and fall. Keep assisting with the rescue breaths until help arrives. If the patient is breathing adequately, stay with the patient until help arrives.
With this in mind, bystanders are the initial first responders in any medical emergency. If you witness someone experiencing an emergency, ask if you may assist them and how you may be of assistance. Simply waiting with them for help to arrive can calm a person's nerves. The less anxiety a patient experiences, the better they may feel.