Seizure First Aid: A Step-By-Step Guide

Key Takeaways

It's important to recognize the various warning signs and symptoms of a seizure. If you suspect someone is having a seizure, stay calm and follow simple steps to keep the person safe.
Time the seizure with a stopwatch and monitor the situation to determine if the person needs emergency medical care.
Keep the person comfortable and make sure they have a clear airway by turning them slightly on their side or sitting them down in a safe place.

What is epilepsy?

Epilepsy is a condition in which abnormal electrical activity in the brain causes seizures or convulsions. A person experiencing a seizure can be confused, unaware of their surroundings, or unconscious, and this can result in injuries. Sudden, unexpected death in people with epilepsy can occur that is not caused by known causes, such as injuries or drowning.

Many people feel uncomfortable dealing with a person experiencing seizure activity. But knowing what to do when someone is having a convulsive seizure can save a life. Please continue reading to learn about seizure first aid and when to seek emergency medical help.

What are the different types of seizures?

Focal (partial) seizures

These types of seizures occur due to abnormal activity on one side of the brain. They are of two types:

Simple partial seizures do not result in loss of consciousness. The symptoms depend on the part of the brain involved and can include visual changes, muscle movements, sweating, nausea, and pale skin.
Complex partial seizures are associated with a loss of consciousness. This type of seizure is also called a focal impaired awareness seizure. It can be associated with unusual behaviors like lip smacking, gagging, screaming, or crying.

Generalized seizures

These seizures involve both sides of the brain and result in loss of consciousness. Generalized seizures are of the following types:

Absence seizure (petit mal seizure) which is characterized by staring, rapid blinking, or face twitching, with a brief period of altered consciousness.
Atonic seizure (drop attack) in which there is a sudden loss of muscle tone and a fall from a standing position, limpness, and unresponsiveness.
Myoclonic seizure, which is characterized by jerking movements that tend to occur in clusters.
Generalized tonic-clonic seizure (grand mal seizure) in which there is a tonic (contraction) phase and a clonic phase when the arms and legs relax.

How to tell if someone is having a seizure?

The signs and symptoms of a seizure depend on the type of seizure. In general, a person having a seizure may have the following symptoms and warning signs:

Staring into space
Stiffening of the body
Jerking of the arms and legs
Rhythmic nodding of the head
Rapid blinking of the eyes
Being unresponsive to noise or speech for a brief period
Appearing dazed or confused
Falling suddenly for no reason
Losing consciousness
Having difficulty breathing or stopping breathing
Losing bowel or bladder control
Lips turning blue

These symptoms can be due to other health conditions besides seizures. It is important for anyone suspected of having seizures to be evaluated by a healthcare provider for a proper diagnosis.

What is the first aid treatment for seizures?

Here is a guide to basic seizure first aid:

Step 1 - STAY

You should stay with the person until the seizure ends. Remain calm even if you don’t have first aid certification. Seizures can be a frightening, confusing, and embarrassing experience for the affected person. Talk to the person in a reassuring tone during and after the seizure. Once they regain consciousness, stay calm and tell them what happened in simple words. Be supportive and sensitive and encourage others to do the same. This will aid in seizure recovery. Offer to call someone or stay until they are fully recovered.

Step 2 - KEEP THE PERSON SAFE

If a person is confused or wandering, keep them safe by moving them away from harmful or sharp objects and dangerous locations such as heights, traffic, or train platforms. In public places, ask other people to step back and give the person some space. Waking up from a seizure in a crowd can be confusing and embarrassing. Check for a medical ID. If you go to find help, ask someone to stay with the person.

Step 3 - TIME THE SEIZURE

Start timing the seizure (use a stopwatch in your smartphone or wristwatch and make a note of when the seizure started and when the seizure stops). Some seizures last only a few seconds. In others, the person’s movements can last several minutes. A seizure can start with minor symptoms but progress to loss of consciousness, a fall, and injuries. Timing the seizure will help you determine if the person needs emergency medical care.

Step 4 - TURN THE PERSON ON THEIR SIDE

If someone is not aware of their surroundings or has lost consciousness, turn the person slightly on their side with their mouth pointing towards the ground. This will help the person breathe by preventing saliva from clogging the airway. Use something soft to support the person’s head. Keep them comfortable (loosen ties and tight clothing), and make sure they have a clear airway. If a person is aware and conscious, sit them down in a safe place or lay them down on the ground to prevent falls.

This seizure first aid poster from the Epilepsy Foundation sums up the above recommendations. You can also visit an online epilepsy learning portal to learn more about first-aid seizure protocols.

What not to do if someone is having a seizure?

Cardiopulmonary resuscitation (CPR)

When someone has a seizure, CPR or rescue breathing is usually not required. During a seizure, there can be changes in a person’s breathing. It may even look like the person has stopped breathing. This can happen due to a tightening of the chest muscles during the tonic phase (muscle contraction phase) of a seizure. However, when the seizure ends, the muscles usually relax, and the person will start breathing normally.

Objects in the mouth

You should not put objects such as a stick, spoon, or wallet in the person’s mouth when they are having a seizure. The jaw and face muscles can contract during seizure activity. Someone having a seizure can injure themselves by biting down on an object in their mouth. For example, they could break their teeth or swallow small parts of the object, resulting in breathing difficulties.

However, if the person has a rescue medication for epilepsy, it can be placed inside the cheek.

Food and drinks

Do not give water, food, or pills to swallow to someone who has had a seizure until they are fully alert. If a person is not fully aware, the pills, food, or water can go down the windpipe instead of the food pipe.

Restraints

You should not restrain someone who is having a seizure. Stopping the person’s movements does not stop the seizure. Instead, it can lead to injuries, confusion, agitation, and aggression. If a person wants to walk around, let them do so as long as the area is safe, and there is no risk of the person falling.