Seizure First Aid: What To Do (And NOT Do) When Someone Has a Seizure

Seizure First Aid: Evidence-Based Do's and Don'ts

Witnessing a seizure is frightening. Proper response prevents injury; improper intervention causes harm.

✅ DO: Immediate Actions

1. Stay calm - Most seizures end in 1-3 minutes
2. Time it - Call 911 if >5 minutes, or another starts immediately
3. Protect from injury:
   • Clear area of hard/sharp objects
   • Cushion head (folded jacket, hands)
   • Loosen tight neckwear
4. Position safely: Roll onto side (recovery position) - prevents aspiration
5. Stay with them until fully alert and oriented
6. Offer reassurance during post-ictal confusion

❌ DON'T: Dangerous Myths

Special Situations

• In water: Support head above water; remove immediately; check breathing
• In wheelchair/seat: Secure straps; cushion head; don't remove unless danger
• Pregnant: Left lateral position; monitor for eclampsia
• Diabetic: Check glucose if known diabetic; don't give oral sugar during seizure

Call 911 If:

• First known seizure
• Seizure >5 minutes (status epilepticus)
• Repeated seizures without recovery
• Difficulty breathing after seizure
• Injury during seizure
• Occurs in water
• Pregnant or diabetic
• No medical ID/known epilepsy

Post-Seizure Care

• Recovery position maintained until alert
• Document: duration, description, triggers, injuries
• Don't leave until oriented to person, place, time
• Encourage medical follow-up

For the Person With Epilepsy

• Wear medical ID
• Share seizure action plan with contacts
• Identify/avoid triggers (sleep deprivation, alcohol, flashing lights, missed meds)
• Discuss rescue meds (benzodiazepines) with neurologist

Key Principle

Protection, not restraint. Your role is creating a safe environment and observing. The seizure will stop on its own. Interventions usually cause more harm than the seizure itself.

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Myth	Reality	Harm
Put something in mouth	Jaw clenched; can't swallow tongue	Broken teeth, jaw injury, airway obstruction, bitten fingers
Restrain the person	Muscular forces exceed your strength	Fractures, dislocations, muscle tears
Give water/food/meds	Swallowing impaired; aspiration risk	Choking, pneumonia
CPR during seizure	Heart usually beating; breathing resumes post-ictal	Delays proper care; rib fractures
Shake/shout to "wake them"	Unconscious; not responsive	Agitation, prolonged confusion