NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 4-year-old female is having a generalized tonic-clonic seizure. Her parents state she has a history of epilepsy, and this seizure has lasted longer than her typical seizures. She is cyanotic around the lips. What is the MOST immediate action for the EMT to take?
- AAdminister prescribed rectal diazepam if available.
- BInsert an oral airway to prevent tongue biting.
- CRestrain the child to prevent injury during the seizure.
- DAdminister supplemental oxygen via non-rebreather mask.
Show answer & explanationAnswer & explanation
Correct answer: D. Administer supplemental oxygen via non-rebreather mask.
During a generalized tonic-clonic seizure, the patient often experiences periods of apnea or ineffective breathing, leading to hypoxia, indicated by cyanosis. Administering supplemental oxygen is the most immediate and critical intervention to address the hypoxia and should be done without delay.
Why the other options are wrong
- A. While anticonvulsants may be indicated for prolonged seizures, addressing hypoxia is the immediate priority for life support.
- B. Inserting an oral airway during an active seizure can cause injury and is generally contraindicated.
- C. Restraining a seizing patient can cause injury to both the patient and the EMT.
Seizure Management: Hypoxia
During a generalized tonic-clonic seizure, hypoxia is a common and dangerous complication due to impaired breathing. Oxygen administration is a priority.
- Protect the patient from injury.
- Do NOT restrain or force anything into the mouth.
- Administer supplemental oxygen for cyanosis or respiratory distress.
- Monitor airway and be prepared to manage post-ictal state.
Memory trick: Protect, Position, Oxygenate, then Paramedics!