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Warning-sign checks

Opisthotonos: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services for a new episode of rigid backward arching, particularly if it is happening now.

    Do not drive yourself while an episode is active.

    Emergency help is especially important if there is:

    • Trouble breathing, blue or grey skin, or choking
    • Fever, a severe headache, a stiff neck, or a new rash
    • Confusion, unusual sleepiness, fainting, or difficulty waking
    • A seizure lasting more than five minutes or repeated seizures
    • A recent head, neck, or back injury
    • A deep or dirty wound with increasing stiffness or spasms
    • Severe jaundice, poor feeding, or unusual sleepiness in a newborn
    • A reaction soon after starting or changing a medicine

    Follow instructions from the emergency call handler.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    If brief arching keeps happening but urgent causes have already been excluded, arrange follow-up with a clinician.

    Babies who repeatedly arch during or after feeds should also be assessed, even if they seem well between episodes.

The article also says

While waiting for help, move nearby objects away and protect the person from falling.

Do not hold the body down or try to force the spine straight.

Do not put anything in the mouth.

Every sign above is quoted from the sofidex article on Opisthotonos. If you are not sure, err upward — it is always reasonable to be checked.