EMS Evaluation—Anxiety into Seizer?

Question

Lets say you’re a paramedic… you come across a patient who is frightened and appears he is not breathing, he starts shaking and does not have a pulse—they appear unresponsive so you verbally tell them to take breaths and administer oxygen. You cannot get blood pressure. Would you evaluate the patient had anxiety from the beginning and it progressed into a seizer? I know EMS gets medical training but I just wanted to know what they would evaluate in this situation and what they would do.

Answer 1

First, the patient appeared frightened, and then started shaking, became apneic and pulseless, and didn't have a blood pressure?

That sounds like a cardiac arrest to me, in which case it's not going to do a lick of good to tell the patient to start breathing and administer oxygen alone. That patient needs to be intubated, CPR started, and appropriate ACLS care administered.

However, I'd like to add that if you just checked a radial pulse, then you might not be getting the full picture. Sometimes, if a person's BP is low, you won't feel a radial pulse, but they will have a carotid pulse. Also, a good BP measurement depends a lot on the skill of the person taking it. I've had Basic students take a BP and get something wildly different than my reading.

A lot of patients experiencing a seizure won't breathe for the duration of the seizure, or will breath very erratically. However, they should still have a pulse. Seizures can be caused by a lot of things, and it may either be the cause of the cardiac arrest, or a result of the cardiac arrest.

Hope this helps...

Answer 2

You can not go from Anxiety into a Seizure. That's a common fear from people who suffer anxiety attacks.

Anxiety raises BP.

When you pass out from hyperventing... you will wake up in a comfortable bed. The EMS will have taken care of you.

Answer 3

don't know where you are going with this question.
Anytime a person is not breathing and you can't get a pulse, where they are having an aura pre-siezure you treat the non-breathing first and the lack of blood pressure

treat the seizure as it develops later.

Answer 4

whatever your initial thought was, you now have a seizure patient. Follow protocol for this, protect from injury, apply o2, observe particulars of seizure activity for later diagnosis.