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

Knowing seizure first aid can prevent injury and save lives. Follow these steps:

Immediate Actions (During Seizure)

1. Stay Calm. Your calmness helps others.
2. Ensure Safety:
   • Gently guide person to floor if not already down.
   • Clear hard/sharp objects.
   • Cushion head (folded jacket, hands).
   • Loosen tight neckwear.
3. Position: Roll onto side (recovery position) as soon as possible – keeps airway open, allows saliva/vomit to drain.
4. Time the Seizure. Note start time; most last 1–3 minutes.
5. Do NOT:
   • Restrain or hold down.
   • Put anything in mouth (fingers, spoon, wallet) – causes dental injury, aspiration, jaw fracture.
   • Give water, food, or pills until fully alert.
   • Attempt CPR during seizure (only if no pulse after seizure ends).
6. Observe & Document: Movements, eye deviation, color, duration, incontinence, injury.

When to Call 911 / Emergency Services

• Seizure lasts >5 minutes.
• Second seizure begins before full recovery.
• First known seizure.
• Injury (head trauma, fracture, laceration).
• Difficulty breathing / cyanosis persists after seizure.
• Occurs in water.
• Person is pregnant, has diabetes, or known heart disease.
• Person does not regain consciousness within 5–10 minutes post-seizure.

Post-Seizure Care

• Keep in recovery position.
• Reassure; explain what happened.
• Allow rest; do not offer food/drink until fully oriented.
• Check for injuries.
• Contact emergency contact / caregiver.

Special Situations

• Wheelchair: Lock brakes, leave in chair if secured, support head, cushion if possible.
• Child: Same steps; febrile seizures common (6 mo–5 yr) – still time, call 911 if >5 min.
• Service dog: Do not separate; dog trained to assist.

Seizure first aid is simple: Protect, Time, Side, Stay.