Seizure First Aid: Step-by-Step Guide for Bystanders

Most seizures self-resolve in 1–3 minutes. Correct bystander response prevents injury and ensures timely EMS activation.

Immediate Actions (During Seizure)

1. Stay Calm and Time It: Note start time. Most critical metric.
2. Ensure Safety: Clear hard/sharp objects. Guide gently to floor if standing.
3. Position: Roll onto side (recovery position) → prevents aspiration. Do NOT restrain.
4. Protect Head: Folded jacket, hands, or flat object under head.
5. Loosen Tight Clothing: Collar, tie, scarf.
6. Do NOT Put Anything in Mouth: Causes dental injury, jaw fracture, aspiration. Tongue biting heals; airway obstruction from objects kills.
7. Observe and Document: Movements, eye deviation, duration, post-ictal state.

Call 911 If:

• Seizure >5 minutes (status epilepticus).
• Second seizure without full recovery.
• First known seizure.
• Difficulty breathing post-seizure.
• Injury during seizure.
• Occurs in water.
• Person is pregnant, diabetic, or has medical ID indicating epilepsy.

Post-Seizure Care

• Stay with person until fully alert (may take 5–30 minutes).
• Reassure; explain what happened.
• Do not offer food/drink until fully oriented.
• Help contact emergency contact/ride.

Special Situations

• Wheelchair: Lock brakes; leave seated if secured; support head.
• Child: Same steps; febrile seizures common 6 months–5 years (call 911 if first or >5 minutes).

Your calm, informed response can save a life. Consider seizure first aid certification (Epilepsy Foundation, Red Cross).