TL;DR
Most seizures end on their own, but knowing how to respond can prevent serious injuries. Learn the simple steps every bystander should take, common mistakes to avoid (like putting something in the person’s mouth), and the warning signs that it’s time to call 911.
A seizure can be a frightening thing to witness, especially for those who have never seen one before. Someone having a seizure may shake, fall, stare blankly, or become unresponsive. As a bystander, you may feel the need to act quickly, but it’s important not to act in haste and cause additional harm. Your goal as a bystander is to prevent the victim from injuring themselves, monitor their breathing, note how long the seizure lasts and when it started, and call 911 if needed.
Most seizures pass on their own within a few minutes. Remember, your goal isn’t to stop the seizure. It’s to make sure the victim is safe until it passes or help arrives.
What a Seizure May Look Like
Seizures do not all look the same. Some involve dramatic full-body movements, while others are subtle.
A person having a seizure may:
- Fall suddenly
- Stiffen or shake
- Stare into space
- Stop responding
- Make repetitive movements, such as lip-smacking or picking at clothing
- Seems confused, frightened, or disoriented
- Wander or act unusually
- Lose bladder control
- Be very tired afterward
Do not assume the person is drunk, using drugs, or behaving strangely on purpose. Confusion and unusual behavior can be part of the seizure or the recovery period.
What to Do During a Seizure
The most important first step is to stay calm and make the area safe.
Do the following:
- Stay with the person.
- Time the seizure from the moment you notice it.
- Gently guide them to the ground if they are falling.
- Move hard, sharp, hot, or dangerous objects away.
- Place something soft and flat under their head, such as a folded jacket.
- Remove eyeglasses if they are wearing them.
- Loosen anything tight around the neck.
- Ask other people to step back and give the person space.
- Speak calmly and reassure those nearby.
If the person is shaking, let the seizure run its course. Do not try to hold them still. The movements are involuntary, and restraining them can cause injury.
What Not to Do During a Seizure
Some common reactions can cause serious harm, even if you’re just trying to help. Avoid the following:
- Do not put anything in the person’s mouth.
- Do not try to hold their tongue.
- Do not give food, water, or medicine during the seizure.
- Do not restrain their arms or legs.
- Do not try to move them unless they are in immediate danger.
- Do not perform CPR unless the seizure has ended and the person is not breathing.
- Do not crowd around them.
- Do not film them or allow others to record the event.
The goal is safety, not control. Protect the person’s head, clear the area, and observe closely.
The Recovery Position
After the active shaking stops, place the person in the recovery position if it is safe to do so.
To use the recovery position:
- Gently roll the person onto their side.
- Position the mouth slightly downward.
- Keep the airway clear.
- Make sure they are breathing.
- Stay beside them until they are alert.
This position helps saliva, fluid, or vomit drain from the mouth and reduces the risk of airway blockage.
Do not give the person anything to eat or drink immediately after the seizure. Wait until they are fully awake, alert, and able to swallow normally.
What to Expect After the Seizure
After a seizure, the person may not immediately return to normal. This recovery period is common and can last several minutes or longer.
They may be:
- Confused
- Sleepy
- Embarrassed
- Upset
- Weak
- Headachy
- Unable to remember what happened
Use short, calm statements. For example:
“You had a seizure. You are safe. I’m staying with you.”
Do not overwhelm them with questions. Once they are more alert, ask simple questions such as:
- “Do you have epilepsy?”
- “Is this type of seizure normal for you?”
- “Do you need medical help?”
- “Is there someone I should call?”
Help protect their privacy and dignity. Ask unnecessary bystanders to move away.
When to Call 911
Call 911 immediately if there are signs of a medical emergency.
Call 911 if:
- The seizure lasts 5 minutes or longer.
- Another seizure starts before the person fully wakes up.
- The person has trouble breathing after the seizure.
- The person appears to be choking.
- The seizure happens in water.
- The person is injured.
- The person hit their head.
- The person is pregnant.
- The person has diabetes or another serious medical condition.
- The person is sick or has a fever.
- This is the person’s first known seizure.
- The person does not regain awareness after the seizure.
- The person asks for emergency medical help.
- You are unsure what is happening.
If you are uncertain, call 911. A prolonged or repeated seizure can be dangerous and requires urgent medical attention.
Common Myths That Can Cause Harm
Misinformation about seizures is common. These myths can lead to dangerous actions.
Myth: “You should put something in their mouth.”
This is false. Never put anything in a person’s mouth during a seizure. They cannot swallow their tongue. Placing objects, fingers, or medicine in the mouth can break teeth, injure the jaw, block the airway, or cause a serious bite injury.
Myth: “You should hold them down.”
This is false. Restraining someone during a seizure can cause muscle, joint, or bone injuries. Move hazards away instead.
Myth: “They need water or medicine right away.”
This is false. A person who is not fully alert may choke. Do not give anything by mouth until they are completely awake and able to swallow safely.
Myth: “All seizures require an ambulance.”
This is not always true. Some people with seizure disorders recover without emergency care. However, seizures lasting 5 minutes or longer, repeated seizures, injuries, breathing problems, seizures in water, or first-time seizures require 911.
Myth: “A seizure means the person is dangerous.”
This is false. A person having a seizure is experiencing a medical event. They need space, safety, and calm assistance.
Final Thoughts
Taking a first aid certification course will help you respond to emergencies with confidence. Seizure first aid is straightforward:
- Stay calm.
- Keep the person safe.
- Time the seizure.
- Do not put anything in their mouth.
- Do not restrain them.
- Roll them onto their side when safe.
- Stay with them until they recover.
- Call 911 when emergency warning signs are present.
A confident, informed bystander can prevent injury, reduce panic, and make a seizure emergency safer for everyone involved.