The first line of response when a person has a seizure is to provide general care and comfort and keep the person safe. The information here relates to all types of seizures. What to do in specific situations or for different seizure types is listed in the following pages. Remember that for the majority of seizures, basic seizure first aid is all that may be needed.
Always Stay With the Person Until the Seizure Is Over
- Seizures can be unpredictable and it’s hard to tell how long they may last or what will occur during them. Some may start with minor symptoms, but lead to a loss of consciousness or fall. Other seizures may be brief and end in seconds.
- Injury can occur during or after a seizure, requiring help from other people.
Pay Attention to the Length of the Seizure
- Look at your watch and time the seizure – from beginning to the end of the active seizure.
- Time how long it takes for the person to recover and return to their usual activity.
- If the active seizure lasts longer than the person’s typical events, call for help.
- Know when to give ‘as needed’ or rescue treatments, if prescribed, and when to call for emergency help.
Stay Calm, Most Seizures Only Last a Few Minutes
- A person’s response to seizures can affect how other people act. If the first person remains calm, it will help others stay calm too.
- Talk calmly and reassuringly to the person during and after the seizure – it will help as they recover from the seizure.
Prevent Injury by Moving Nearby Objects Out of the Way
- Remove sharp objects.
- If you can’t move surrounding objects or a person is wandering or confused, help steer them clear of dangerous situations, for example away from traffic, train or subway platforms, heights, or sharp objects.
Make the Person as Comfortable as Possible
- Help them sit down in a safe place.
- If they are at risk of falling, call for help and lay them down on the floor.
- Support the person’s head to prevent it from hitting the floor.
Keep Onlookers Away
- Once the situation is under control, encourage people to step back and give the person some room. Waking up to a crowd can be embarrassing and confusing for a person after a seizure.
- Ask someone to stay nearby in case further help is needed.
Do Not Forcibly Hold the Person Down
- Trying to stop movements or forcibly holding a person down doesn’t stop a seizure. Restraining a person can lead to injuries and make the person more confused, agitated or aggressive. People don’t fight on purpose during a seizure. Yet if they are restrained when they are confused, they may respond aggressively.
- If a person tries to walk around, let them walk in a safe, enclosed area if possible.
Do Not Put Anything in the Person’s Mouth!
- Jaw and face muscles may tighten during a seizure, causing the person to bite down. If this happens when something is in the mouth, the person may break and swallow the object or break their teeth!
- Don’t worry – a person can’t swallow their tongue during a seizure.
Make Sure Their Breathing is Okay
- If the person is lying down, turn them on their side, with their mouth pointing to the ground. This prevents saliva from blocking their airway and helps the person breathe more easily.
- During a convulsive or tonic-clonic seizure, it may look like the person has stopped breathing. This happens when the chest muscles tighten during the tonic phase of a seizure. As this part of a seizure ends, the muscles will relax and breathing will resume normally.
- Rescue breathing or CPR is generally not needed during these seizure-induced changes in a person’s breathing.
Do not Give Water, Pills, or Food by Mouth Unless the Person is Fully Alert
- If a person is not fully awake or aware of what is going on, they might not swallow correctly. Food, liquid or pills could go into the lungs instead of the stomach if they try to drink or eat at this time.
- If a person appears to be choking, turn them on their side and call for help. If they are not able to cough and clear their air passages on their own or are having breathing difficulties, call 911 immediately.
Call for Emergency Medical Help When
- A seizure lasts 5 minutes or longer.
- One seizure occurs right after another without the person regaining consciousness or coming to between seizures.
- Seizures occur closer together than usual for that person.
- Breathing becomes difficult or the person appears to be choking.
- The seizure occurs in water.
- Injury may have occurred.
- The person asks for medical help.
Be Sensitive and Supportive, and Ask Others to Do the Same
- Seizures can be frightening for the person having one, as well as for others. People may feel embarrassed or confused about what happened. Keep this in mind as the person wakes up.
- Reassure the person that they are safe.
- Once they are alert and able to communicate, tell them what happened in very simple terms.
- Offer to stay with the person until they are ready to go back to normal activity or call someone to stay with them.
Authored by: Steven C. Schachter | MD
Reviewed by: Patricia O. Shafer RN MN on 2/2014