Seizure Management and Heimlich Maneuver Steps

What is a seizure?

Seizures occur when there is uncoordinated activity in the brain leading to temporary changes in behavior movements (such as stiffening and jerking of the arms and legs) sensations or even loss of consciousness or altered levels of awareness.

What are the different types of seizures?

Seizures can be classified based on where they originate in the brain, whether a person remains aware during the seizure and whether there is any movement involved.

There are three categories, for classifying seizures;

  • Focal onset seizures begin in a region of the brain (known as the focus). May spread to other areas. These were previously referred to as seizures. During these seizures a person might be fully aware of their surroundings ( aware). Experience some level of awareness impairment (focal impaired awareness).
  • Generalized onset seizures affect both sides of the brain from the start often resulting in loss of consciousness. Generalized motor seizures involve stiffening and jerking movements, also known as tonic clonic seizures (previously called mal) or other muscular effects. Generalized non motor seizures result in changes in awareness, such as staring or repetitive movements, like lip smacking or pulling at clothes.
  • Unknown onset seizures refer to those that haven’t been categorized as either focal or generalized because its uncertain where the seizure originated in the brain. This uncertainty may arise when a person was asleep or alone when the seizure began.
Seizure Management

During a Seizure: Immediate Actions

  • Call for the nurse immediately. 
  • Use the emergency light. 
  • Shout for assistance. 
  • If the patient is, in bed raise the side rails. 
  • Place a pad or blanket to prevent any injuries. 
  • In case the patient is seated, gently lower them to the floor and ensure that there are no obstacles or furniture in their vicinity. 
  • To avoid any aspiration turn the patients head to one side. It’s essential to loosen any clothing, around their neck area. 
  • Remember not to put anything in the patients mouth or attempt to restrain them during this time. 
  • Make sure you take note of when the seizure started or when you discovered the patient and also record when it ends. Provide privacy by clearing out any visitors from the area. 
  • Once the seizure has stopped, cover the patient with a blanket. Stay by their side until they regain alertness.

Heimlich Maneuver Steps

What is the Heimlich Maneuver? 

The Heimlich Maneuver, also called Abdominal Compression, is a first aid procedure to clear the respiratory tract, blocked by a piece of food or any other small object. It is an effective method to save lives in case of choking. Asphyxia prevents oxygen from reaching the lungs and from there to the rest of the organs. If the brain remains without oxygen for more than four minutes, some brain damage or even death can occur. Currently, it is recommended that the Heimlich maneuver should be used only in the case of severe airway obstruction, in which the person can no longer make any noise.  Whereas in a person with a mild obstruction, in whom he can still cough, his attempts to expel the object on his own should not be hampered. In cases of pregnant women, obese or very large people, the technique should be modified by chest compressions, following the same dynamics as abdominal compressions. Blows to the back can aggravate the obstruction, due to the gravitational force, turning a minor obstruction into a serious one.

How is the Heimlich maneuver done?

Knowing how to do the Heimlich maneuver correctly can prevent choking in both children and adults . Even if it happens to yourself, it can save your life if you are alone or if no one around you knows how to practice this maneuver.

Likewise, it should be borne in mind that, although the maneuver has the same objective for anyone who is suffering from choking, there are slight nuances that must be pointed out, depending on whether it is a nursing baby, a child, an adult or yourself.

Finally, it must be taken into account that, if in a first attempt, we do not manage to get the person to expel the element that is making breathing impossible, it is best to ask for help so that someone, while you continue trying the Heimlich maneuver with the victim of choking, calls the emergency telephone number and first aid experts can come as soon as possible .

The Heimlich maneuver in adults

To perform the Heimlich maneuver in adults, it is important that you follow the following steps:

  • Wrap your arms around the waist of the person who is choking.
  • Clench your fist tightly and place it above the navel, just below the ribcage.
  • With the other hand, hold your fist to be able to exert a greater force.
  • Give 6 to 10 compressions in an inward and upward direction, just below the ribcage.

If after performing the first series of 10 compressions, the person continues to choke, you should repeat the maneuver again until the object or piece of food is expelled.

The Heimlich maneuver in children

It is important to keep in mind that if you ever have to help a child who is choking, you should not apply the same force as an adult , as this could cause a rib injury or fracture and even damage to internal organs. Although if too much pressure is exerted, this could also happen in an adult person. Even so, the force must also be adapted to the age and size of the child in question.

  • Before proceeding with the Heimlich maneuver, if the child is older than 1 year, you should give 5 blows with the heel of the hand on the back , since sometimes with this gesture it is already solved.
  • If this does not work, you should go on to perform the Heimlich maneuver. To adapt to the height of the child , especially those who weigh less than 20kg and are under 5 years of age, you must stand behind him , either kneeling or sitting.
  • Once behind, you will have to surround the little one with your arms , in the same way as an adult, and you will have to locate the solar plexus (just above the pit of the stomach) to begin the maneuver.
  • Unlike, with adults, you will not use a clenched fist, but you will put your hands in the shape of a spoon and help yourself by putting your other hand on top.
  • In this position you must perform 5 compressions trying not to lift the child off the ground.

In the same way as in the case of adults, the Heimlich maneuver should be repeated until the child expels the object or piece of food and can breathe. Of course, if the child loses consciousness, we must stop doing compressions and start performing pulmonary resuscitation maneuvers while we call emergencies.

The Heimlich maneuver in babies under 1 year of age

Babies can also choke, usually caused by swallowing a foreign object. If it is a baby under 1 year old, you must be even more careful with the pressure we exert so as not to cause other types of damage.

  • Before proceeding with the Heimlich maneuver, you can start by tapping the heel of your hand 5 times on the back , where the shoulder blades are.
  • If the object does not come out, but is accessible, you can try to remove it with your own fingers . It is important that you apply this step only in those cases in which you can easily reach the object, otherwise it would cause the baby to choke even more.
  • Finally, if you have not achieved them, you must proceed to the Heimlich maneuver , which varies on the other groups of people. In this case, you will have to place your index and middle fingers together and put pressure on the breastbone (it will sink a little), right in the middle of the two nipples.
  • Right at that point, you will have to perform 5 compressions, trying not to apply too much pressure to harm the baby.

If, unfortunately, this doesn’t work, it’s important that you call 911 while you keep trying again.

The Heimlich maneuver for pregnant or obese people

These groups of people are more delicate when it comes to receiving the Heimlich maneuver, therefore, it is something that we must take into account before practicing it in the wrong way.

In pregnant people

Abdominal thrusts should not be performed on a pregnant woman, as they could affect the fetus. For this reason, in the event of a pregnant woman choking, it is recommended to lay her on the floor with her head to one side and that compressions be performed on the sternum.

In obese people

In persons with obesity problems we can find that it is difficult or practically impossible to surround the victim by the upper part of the abdomen and it is recommended to lay her on the floor with her head tilted, but, unlike pregnant women, perform compressions in the pit of the stomach normally.