In a patient with a tonic-clonic seizure lasting more than 15 minutes, which course of action is MOST appropriate?

In a patient with a tonic-clonic seizure lasting more than 15 minutes, which course of action is MOST appropriate?

• A. perform a blood glucose test
• B. attempt to open the patient's mouth and insert a bite stick
• C. immobilize the patient to a spinal board and initiate transport
• D. secure an airway and place the patient in a safe position

Answer: (D)

When a tonic-clonic seizure is prolonged, the immediate priority is to secure the airway and protect the person from injury. Placing them in the recovery position on their side helps keep the airway open and allows secretions to drain, reducing the risk of aspiration. Keep the head supported and the environment clear of hazards, and avoid placing anything in the mouth or attempting to force the jaw open—these actions can cause injury and do not safely prevent airway obstruction. Do not restrain the person to a spinal board during an active seizure, as this can hinder breathing and movement and delay airway management. Stay with them, monitor breathing, and be ready to suction or provide oxygen as needed. After the seizure subsides, proceed with further assessment and transport. Checking blood glucose can be part of the overall assessment, but it does not address the immediate need to secure the airway and prevent injury during a prolonged seizure.

When a tonic-clonic seizure is prolonged, the immediate priority is to secure the airway and protect the person from injury. Placing them in the recovery position on their side helps keep the airway open and allows secretions to drain, reducing the risk of aspiration. Keep the head supported and the environment clear of hazards, and avoid placing anything in the mouth or attempting to force the jaw open—these actions can cause injury and do not safely prevent airway obstruction. Do not restrain the person to a spinal board during an active seizure, as this can hinder breathing and movement and delay airway management. Stay with them, monitor breathing, and be ready to suction or provide oxygen as needed. After the seizure subsides, proceed with further assessment and transport. Checking blood glucose can be part of the overall assessment, but it does not address the immediate need to secure the airway and prevent injury during a prolonged seizure.