Precautions for Swimmers with Seizures

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New Years’ resolutions will bring many people to JCCs for exercise and weight loss. Since about 1.5 million people in the US suffer from some type of seizure disorder, it is certain that some of the newcomers will be people who suffer seizures.

The severity of a seizure is determined by its type and length. Most people’s visual image of a seizure involves a person whose muscles are wrenching violently, but most seizures actually result only in a one or two minute altered state of consciousness and loss of muscle tone.

Swimming and other water activities are ideal ways to begin an exercise program, but they hold inherent risk for individuals prone to seizures. Seemingly less serious seizures can be deadly in the water because the person becomes limp and unresponsive which is the reason that a bathtub is a common place for people with seizures to drown.

People with seizures can drown even if they know how to swim. These drownings can occur quickly and quietly, often giving the lifeguard little time to respond.

Prevention is therefore critical.

Redwoods’ insured organizations reported 172 seizures from December 2007 to December 2008. These occurred in many places: locker rooms, cardio-floors, child watch areas, after-school sites, and pools.

  • 19% of these seizures involved a program participant who had repeated episodes
  • Fewer than 3% of the seizures occurred in a swimming pool; however all required CPR and hospitalization
  • The small number of pool seizures noted above accounted for 14% of the total aquatic incidents reported during the same time period

A recent article published in Neurology, the medical journal of the American Academy of Neurology, states that people with epilepsy have a 15 to 19 times greater risk of drowning than do people in the general population. The article also states that this risk was highest in people who have both epilepsy and a learning disability. The study found that the increased risk of drowning is greater with adults than it is with children because of the direct supervision generally given by a parent or caregiver. During the time period, 75% of the seizures that occurred in Redwoods’ insured pools involved individuals who were over 18 years old.

Seizures during exercise are reportedly rare when overexertion, hypothermia (decrease in body temperature), dehydration, hypoventilation (breath holding), and hypoglycemia (low blood sugar) are avoided, according to the Epilepsy Foundation. Photosensitivity is a rare trigger – if this is a known problem the swimmer should wear polarized goggles or sunglasses when in the pool.

Regardless of their history of frequency or severity, people with seizures should follow these guidelines:

  • Use a shower for bathing instead of a bathtub – doing so avoids the number one cause of death by seizure
  • Get clearance from your healthcare provider before starting a swimming regimen
  • Inform the on-duty lifeguard or swim-lesson instructor about the potential for seizure and wear a brightly colored swim suit so they can more easily keep track of you
  • Swim with a companion who can provide one-on-one supervision
  • Have a plan for when a seizure occurs in the water and communicate it with those nearby
  • Swim early in the day to avoid fatigue
  • Stop swimming if fatigued, if not feeling well, if medications were missed, or if you feel warning signs of a possible seizure
  • People with poorly controlled seizures should wear a brightly colored lifejacket and have a pool companion within arm’s reach
  • Do not dive head-first into the water
  • Use whirlpools or spas only with supervision

Following are a few steps that can prepare your camp to handle seizures in the water.

  • Have aquatic staff train and regularly practice how to handle a seizure in the water
    • Support the victim’s head, keeping the face out of the water
    • Remove the victim from the water and evaluate breathing
    • Place the victim in recovery position on his/her side
    • Perform CPR if needed after the spasms have stopped
    • Treat seizures as an emergency if they last longer than five minutes or if a person has multiple seizures and does not arouse afterwards
  • Educate members about the importance of informing the aquatic staff of their possibility (or propensity) to have seizures. This can be accomplished through newsletters, email blasts, registration information, and through word of mouth during aquatic programs
  • Place signage warning about the dangers of seizures that occur in the water
  • November is National Epilepsy Awareness Month; organize activities during this month in all departmental programs
  • Ask if there are any known health problems on all program and membership registrations. Discuss with the individual the importance to inform program staff, especially aquatic staff, of the potential for seizures

It’s not just kids who are at risk. Seizures in the water can happen quickly and are often very difficult to recognize. Lifeguards should remain diligent when scanning lap swimmers, open swimmers, and special needs individuals. The best preparation is education, communication, and repeated practice of emergency response techniques for seizures in the water.

Please call us at 800-463-8546 to discuss this or any other risk management safety tip, or visit our web site at www.redwoodsgroup.com to learn more about JCC risk management issues.

Comments 

  • Posted October 31, 2014 5:18 AM by jhonpeter60

    Topamax is an antiepileptic drug prescribed to prevent and control seizures (epilepsy). This seizure medication, an anticonvulsant, is also used to prevent migraine headaches.

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