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What to do during and after a seizure?

During a seizure

Protect the person from injury. Keep him or her from falling if you can, or try to guide the person gently to the floor. Try to move furniture or other objects that might injure the person during the seizure. If the person is having a seizure and is on the ground when you arrive, put something soft under his or her head. Do not force anything, including your fingers, into the person’s mouth. Putting something in the person’s mouth may cause injuries to him or her, such as chipped teeth or a fractured jaw. You could also get bitten. Turn the person onto his or her side, with the mouth down, unless the person resists being moved. Do not try to hold down or move the person. Try to stay calm. If the person vomits, turn the person onto his or her side. Pay close attention to what the person is doing so that you can describe the seizure to rescue personnel or doctors. 1. What kind of body movement occurred? 2. How long did the seizure last? 3. How did the person act immediately after the seizure? 4. Are there any injuries from the seizure? 5. Time the length of the seizure, if possible.

After a seizure

Check the person for injuries. If you could not turn the person onto his or her side during the seizure, do so when the seizure ends and the person is more relaxed. If the person is having trouble breathing, use your finger to gently clear his or her mouth of any vomit or saliva. Loosen tight clothing around the person’s neck and waist. Provide a safe area where the person can rest. Do not give anything to eat or drink until the person is fully awake and alert. Stay with the person until he or she is awake and familiar with the surroundings. Most people will be sleepy or confused after a seizure. A person who has had a seizure should not drive, swim, climb ladders, or operate machinery until he or she has seen a doctor about the seizure and the doctor has said that the person is allowed to drive or operate machinery.

Patient Transfer Techniques

The Occupational Safety and Health Administration (OSHA) recommend that, “Manual lifting of residents be minimized in all cases and eliminated when feasible.” The American Nursing Association finds that, “Every day, nurses suffer career-ending and life-altering injuries from repeatedly lifting and moving patients,” and outlines sound ergonomic practices to help transfer patients properly. The same principles apply to caregivers transferring patients in home settings. Physical and occupational therapists are often the first to stand and transfer you after surgery or injury. Transfers, or moving from the sitting to standing position or moving from one seated surface to another, are integral to completing many vital daily tasks. Your therapist needs to see that you, with the assistance of a family member if needed, can safely transfer and stand in order to return home after hospitalization or rehabilitation stay.

Patient Rights and Privacy

Patients’ rights are very different. There are few rights that are clearly spelled out, except those that regard privacy or the ability to obtain our medical records, as determined through the federal HIPAA Act. Individual states have enacted other laws that usually impact only hospital care. More often, individual facilities (like hospitals) or physician practices will offer up their own list of patients’ rights. However, it’s unclear as to whether those could ever be enforced if there is a problem. However, there are a number of rights that are accepting as being true, even though they may not be officially recorded anywhere. Some are simply based on respect. Others are based on our responsibilities as human beings. Others have evolved as the need warrants. The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety.

Proper Observation and Documentation

When a patient is admitted for observation, insurance companies and Medicare typically require documentation consisting of an order of hospital admission that defines the level of care the doctor recommends. This information can be documented with a telephone call to the payer. Documentation must also include hospital admission and discharge reports. A discharge order must also be documented and can be provided by phone. It is also useful to provide hospital treatment orders and progress notes for other reasons, though this is not required for reimbursement. Services not considered reasonable or necessary for diagnosis and treatment are not covered.

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