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This scenario describes a grand mal or tonic clonic seizure, which occurs most commonly in people with epilepsy. Most seizures only last a matter of minutes, and are caused by an abnormal burst of electrical activity in the brain. After the warning cry (which may not always occur), the person’s trunk and limb muscles become rigid. They may grunt or froth at the mouth, and possibly urinate. The person’s face may turn blue, but this will sort itself out as soon as the seizure subsides. After a moment, the person will begin jerking their arms and legs violently (convulsing), for a few seconds to several minutes.
When someone is having a seizure, the most important thing you can do is ensure they don’t breathe in any vomit or injure themselves while they are convulsing. You can protect the person by placing them in the recovery position.
To place someone in the recovery position, lie the person on their side, tilted slightly forward. Arrange their lower arm (the one on the ground) straight out from the shoulder, and pull the leg on the same side straight down. Bend the other arm at the elbow and place the hand under the cheek. Bend the leg on this side at the hip and knee, which will hold them in position.
Most epileptics don’t need to go to hospital for a seizure. However, ring 000 for an ambulance if the seizure goes on for more than five minutes, is followed by another seizure soon afterwards or there is no one who can look after the person for a couple of hours. Read our Epilepsy fact file for more information. You see a middle aged man suddenly become distressed. He appears to be choking and points to his throat. He cannot speak and is becoming bluish in colour. What should you do?
Answer: d) Ask him to bend forward and give him a series of hard thumps to his upper back.
Bend the person forward and give them a series of firm thumps between the shoulder blades.
If the person still can’t breathe, keep them bent forward and, supporting their back with one hand, perform strong, sudden chest compressions with the other hand
Don’t try the ‘abdominal thrust’ (Heimlich manoeuvre) it’s no longer recommended for this type of emergency
If a person inhales a piece of food into their voice box (larynx), they will be unable to speak or breathe in adequately and won’t be able to take in enough air to cough and clear their larynx. This situation occurs more commonly in young children and older people with dentures.
If you are with someone and they start choking you should bend the person forward and give them up to five sharp thumps between their shoulder blades. Don’t be gentle give a good whack using the heel of your hand.
If the person still can’t breathe, keep them bent forward, supporting their back with one hand. Place your other hand over their breast bone and compress their chest five times. If a baby is choking, drape it along your forearm. Your arm should be between the baby’s legs and your hand under the upper body. Again, modify the force of your thumps according to the size of the child. You are a member of a search party and have found the missing person, who has been lost overnight in the mountains in winter. The person is inadequately dressed and very wet. What should you do?
Answer: c) Protect him from the wind, remove his wet clothes, dry him and wrap him in blankets and a space blanket as soon as possible