Nursing management of reflex anoxic seizures in children
Evidence & Practice    

Nursing management of reflex anoxic seizures in children

Neal Patel Year 4 medical student, University of Bristol, Bristol, England
Rowan Kerr-Liddell Consultant paediatrician, Torbay Hospital, Torquay, Devon, England
Louise Challis Children's community respiratory, cardiac and neonatal nurse specialist, Torbay Hospital, Torquay, Devon, England
Siba Paul Consultant paediatrician, Torbay Hospital, Torquay, Devon, England

Children who present with transient loss of consciousness (T-LOC) are often first seen in emergency departments (EDs). Reflex anoxic seizure (RAS), vasovagal syncope and prolonged respiratory apnoea are benign, syncopal events that can be generally managed by explanation and reassurance. RAS is a short, paroxysmal, self-reverting episode of asystole that is triggered by pain, fear or anxiety and is caused by increased vagal response. It is an important differential diagnosis in pre-school age children who present with T-LOC, but is often underdiagnosed and can sometimes be misdiagnosed as epilepsy. Nurses working in EDs are among the first healthcare professionals to see children in acute settings and should therefore be aware of RAS, the presenting features and management options. This article discusses the epidemiology, pathophysiology and management of RAS, includes an illustrative case study and discusses the role of ED nurses.

Emergency Nurse. doi: 10.7748/en.2017.e1646

Correspondence

siba.paul@nhs.net

Peer review

This article has been subject to double-blind review and checked for plagiarism using automated software

Received: 19 September 2016

Accepted: 28 November 2016

Published online: 05 April 2017