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Seizures, Lateral Decubitus, Aspiration, and Shoulder Dislocation
Neurol 56:290-291, DeToledo,J.C.&Lowe,M.R., 2001
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Article Abstract
Although no study has specifically addressed the problem of aspiration pneumonia in adults with GTCS, our findings suggest this problem is not common. From the two epilepsy centers, 5 of 806 patients dislocated a shoulder during a seizure. Video recordings showed that these patients were positioned in a lateral decubitus by staff while still having the convulsion. The dislocated shoulder in all cases was on the lower side. The risk of shoulder dislocation in a convulsing patient positio ned in a lateral decubitus is less than 1%. Nevertheless, dislocations can result in disabling recurrences and are easily preventable. Because aspiration is more likely in the postictal rather than ictal phase of a GTCS, when oral secretions are not usu ally increased and there is cessation of respiratory movements, lateral decubitus should only be implemented after cessation of the convulsion. In inpatients (such as those on telemetry), secretions may be better managed by bedside aspiration of the oral cavity.
 
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aspiration
restraint,mechanical
review article
seizure
seizure,complications following
shoulder,dislocation

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