Ask these questions if an infant is seizing
"Undiagnosed or new-onset seizure in infants is always a critical emergency, mostly because we need to figure out the underlying cause and treat it before it worsens," says Jennifer Anders, MD, an ED physician at Johns Hopkins Children's Center in Baltimore.
Common causes of seizure in previously healthy young infants are sepsis, meningitis or encephalitis, metabolic disease, hypocalcemia, hyponatremia, or hypoglycemia, says Anders.
"In general, seizure is life-threatening for infants only when it causes prolonged apnea or hypoventilation," says Anders. "The danger would come from hypoxia."
Because the infant might no longer be seizing by the time the parents arrive at the ED, obtaining an accurate history and timeline is very important, says Mary Frey, RN, P-SANE, CPN, ED nurse at Cincinnati Children's Hospital Medical Center. She recommends obtaining the following information from the parent or caregivers who witnessed the seizure:
- How long did the seizure last?
- What part of the body was involved? Did the seizure progress to other parts of the body during the event?
- Did the infant stop breathing during the seizure? If so, what interventions were done?
- Does the infant have a history of seizures?
- Does the infant have a history of illness?
- Does the infant have a history of injury?
- Does the infant drink water? How much per 24 hours? How is formula being prepared? Either of these situations can be life-threatening, says Frey:
— prolonged seizure activity lasting more than 10 minutes;
— frequent seizures without the patient returning to his or her baseline neurological status between the seizures.
"Status epilepticus is a medical emergency and needs immediate interventions," says Frey. "Maintaining the airway and establishing intravenous access for medication administration is crucial."
"Undiagnosed or new-onset seizure in infants is always a critical emergency, mostly because we need to figure out the underlying cause and treat it before it worsens," says Jennifer Anders, MD, an ED physician at Johns Hopkins Children's Center in Baltimore.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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