How should you manage a field seizure?

• A. Move patient to a safe area, restrain; hold limbs.
• B. Move patient to a safe area, do not restrain; cushion head and protect from injury; time seizure; after, check airway and breathing; if seizure lasts >5 minutes or recurs, evacuate.
• C. Restrain and inject benzodiazepine.
• D. Do nothing.

Answer: (B)

Managing a field seizure centers on safety, airway, breathing, and knowing when to evacuate. Move the person to a safe area to prevent injury and remove nearby hazards, but don’t try to restrain the limbs. Cushion the head, loosen tight clothing, and clear the area of hard objects. Never put anything in the mouth, and avoid restraining the person or injecting any medication. As the seizure ends, check that the airway is clear and the person is breathing; if possible, place them on their side in a recovery position and continue to monitor until fully alert. Time the seizure from onset. If it lasts more than five minutes, or another seizure occurs soon after, evacuate or seek higher level care. In the wilderness, seek help promptly if there are injuries, the person does not regain consciousness, or there are other risk factors, and only use medications if you have explicit medical direction. This approach focuses on preventing injury, protecting the airway, and making a timely decision to evacuate when needed.