ABSTRACT
The causes can usually be narrowed down effectively by taking a history from nursing staff, looking through the patient’s notes and drug card, and examining the patient. Whilst many different types of seizure exist, when staff in hospital refers to a ‘fitting patient’, they are generally making reference to a ‘tonic clonic’ seizure. These manifest as a loss of consciousness with repeated and often vigorous motor movements of all four limbs. Being faced with a fitting patient can be quite alarming at first, but fortunately the basic management steps are logical and straightforward. If a patient has an anterior basal skull fracture, there is a theoretical risk that the nasopharyngeal (NP) airway may pass through the sphenoidal sinus into the brain. Therefore, if a NP airway is the only immediate option available in a patient with a head injury and an obstructed airway, the decision should be made by a senior doctor.
