What is the highest priority in treating an actively seizing patient?

• A. Place in Trendelenburg
• B. Check blood pressure
• C. Ensure airway protection
• D. Administer glucose

Answer: (C)

During an active seizure, the most urgent need is to protect the airway. Seizures disrupt the body's natural protective reflexes, which can cause the tongue to obstruct the throat, block the airway with secretions or vomitus, and lead to dangerous breathing or aspiration. The immediate goal is to keep the airway open and ensure adequate ventilation and oxygenation. This means positioning to favor an open airway, turning the patient onto their side if possible, suctioning secretions or vomit, avoiding any object in the mouth, and providing oxygen as needed while monitoring respirations. Once the airway and breathing are stabilized, other concerns like blood pressure or glucose treatment can be addressed. Trendelenburg positioning isn’t helpful and can cause harm, and glucose is only an immediate concern if hypoglycemia is suspected. If seizures persist or respiration is inadequate, follow protocol for advanced airway support and medications.