Category: Health & Safety

What to Do When Someone Has a Seizure

A seizure occurs when there is a sudden change in the brain’s electrical activity. Some seizures cause a person to fall, lose consciousness, become stiff, and experience repeated jerking movements. Others may cause staring, confusion, unusual behavior, or a brief loss of awareness without any dramatic movement.

Most seizures stop on their own within a few minutes. During that time, the most important things you can do are protect the person from injury, time the seizure, stay with them, and know when to call 911.

Do not hold the person down, put anything in their mouth, or attempt to stop their movements. These actions can cause serious injuries.

Seizures Do Not All Look the Same

A seizure may involve:

• Falling
• Sudden loss of consciousness
• Stiffening of the body
• Rhythmic jerking
• Muscle twitching
• Repeated blinking
• Staring
• Lip smacking
• Chewing movements
• Picking at clothing
• Wandering
• Sudden confusion
• Repeating words or actions
• Not responding normally
• A sudden loss of muscle tone
• Unusual sensations, smells, tastes, or emotions

A person may remain partly aware during some types of seizures. During others, they may be unable to respond or remember what happened.

Do not assume someone is ignoring you, intoxicated, behaving intentionally, or experiencing a mental health problem. Calmly protect them until their awareness returns.

Stay Calm and Begin Timing

Look at a clock, watch, or phone as soon as you recognize that a seizure may be occurring.

Record:

• When the seizure began
• How long it lasted
• Which body parts were involved
• Whether the person lost consciousness
• Whether breathing or skin color changed
• Whether another seizure followed
• How long recovery took

Timing is important because a seizure lasting five minutes or longer is a medical emergency.

If you are not sure exactly when it began, make your best estimate and tell emergency responders.

Protect the Person From Falling

If the person appears to be losing consciousness:

• Help them toward the floor.
• Guide them away from stairs, traffic, water, glass, machinery, or fire.
• Do not try to hold them upright.
• Do not attempt to carry them unless they are in immediate danger.

If they are already on the ground, allow the seizure to continue there.

Clear the Area

Move nearby objects that could cause injury, such as:

• Chairs
• Tables
• Tools
• Glass
• Hot drinks
• Sharp objects
• Electrical equipment
• Space heaters
• Heavy decorations

Ask bystanders to step back. Give the person as much privacy as possible while maintaining enough space to provide care.

Do not move the person unless they are near an immediate danger that cannot be removed.

Protect the Head

Place something soft and flat beneath the person’s head, such as:

• A folded jacket
• A sweater
• A small pillow
• A folded towel

Remove eyeglasses when you can do so safely.

Do not place a large object beneath the head or force the head into a particular position. Do not attempt to stop the head or body from moving.

Loosen Tight Clothing

Loosen anything tight around the neck, including:

• Ties
• Scarves
• Tight collars
• Lanyards
• Necklaces

Do not completely undress the person. Maintain privacy and avoid unnecessary movement.

Turn the Person Onto Their Side

When it can be done safely, gently turn the person onto one side with the mouth angled toward the ground. This position can help saliva, blood, or vomit drain from the mouth.

Do not use force or struggle against the person’s movements. If turning them during the active seizure is unsafe, protect them from injury and place them on their side as soon as the movements stop.

Support the head and keep the airway clear.

The CDC recommends staying with the person, clearing dangerous objects, placing something soft beneath the head, loosening tight neckwear, positioning the person on their side, and timing the seizure. CDC: First Aid for Seizures

Do Not Put Anything in the Person’s Mouth

A person cannot swallow their tongue during a seizure.

Never place any of the following in the mouth:

• Your fingers
• A spoon
• A wallet
• A cloth
• A bite block
• Food
• Water
• Pills
• Oral medication

Putting something in the mouth can:

• Break teeth
• Injure the jaw
• Block the airway
• Cause choking
• Injure you
• Push fluid or medication into the lungs

Do not attempt to force the mouth open.

Do Not Restrain the Person

Do not:

• Hold down the arms or legs
• Sit on the person
• Attempt to stop the movements
• Tie or secure the person
• Force them into a chair
• Shout commands at them
• Slap or shake them

Restraining someone can injure their muscles, joints, or bones. It can also cause panic and defensive behavior as awareness begins returning.

Your role is to protect the person from surrounding hazards, not stop the seizure physically.

Do Not Give CPR During Active Jerking

Breathing may appear irregular during a convulsive seizure. The person may make sounds, become pale, or briefly develop a bluish or grayish color.

Do not attempt mouth-to-mouth breathing or chest compressions while active seizure movements are continuing.

Once the seizure stops:

1. Check whether the person is breathing normally.
2. Position them on their side when they are breathing.
3. Call 911 and begin CPR if they are not breathing normally.
4. Use an AED when one is available.
5. Follow the dispatcher’s instructions.

Gasping or occasional irregular breaths are not normal breathing.

Helpful Resources: Browse CPR & Emergency Response Supplies for products, equipment, services, or supplies related to this section.

Know When to Call 911

Call 911 or your local emergency number when:

• The seizure lasts five minutes or longer.
• Another seizure begins before the person recovers.
• The person has trouble breathing after the seizure.
• The person does not begin waking after the seizure.
• It is the person’s first known seizure.
• The person was injured.
• The seizure occurred in water.
• The person is pregnant.
• The person has diabetes and lost consciousness.
• The person may have been poisoned or overdosed.
• The seizure followed a serious head injury.
• The seizure is different from the person’s usual seizures.
• The person’s seizure action plan directs you to call.
• You are uncertain whether the event is a seizure.
• You are worried about the person’s condition.

Seizures lasting five minutes or longer or occurring back-to-back without recovery may represent status epilepticus, a life-threatening medical emergency.

Follow the Person’s Seizure Action Plan

Someone with epilepsy may have a written seizure action plan explaining:

• What their usual seizures look like
• How long they typically last
• When to call 911
• Whether rescue medication is prescribed
• How and when the rescue medication should be given
• Whether a second dose is allowed
• Who should be contacted
• What recovery usually looks like

Look for:

• A medical alert bracelet
• A wallet card
• A phone medical ID
• Instructions stored with medication
• Information provided by a caregiver

Follow the plan unless the person has emergency symptoms requiring immediate 911 assistance.

Rescue Medication

Some people with epilepsy have prescription rescue medication for prolonged seizures or seizure clusters. It may be provided as:

• A nasal spray
• A rectal medication
• Another product prescribed for the person

Only give rescue medication when:

• It was prescribed for that person.
• The seizure action plan says to use it.
• You have been trained to administer it.
• You can follow the product instructions safely.

Do not give someone another person’s rescue medication. Do not guess the dose or repeat it without instructions.

Do not place an oral medication into the mouth of someone who is unconscious or actively convulsing.

Call 911 when required by the action plan, when the seizure continues after medication, when breathing changes, or when you are concerned about the person.

After the Seizure Stops

The period after a seizure is sometimes called the postictal period. The person may be:

• Confused
• Sleepy
• Frightened
• Embarrassed
• Weak
• Sore
• Tearful
• Irritable
• Unable to speak clearly
• Unable to remember what happened
• Experiencing a headache

Stay with them.

Speak calmly:

“You had a seizure. You’re safe. I’m staying with you.”

Tell them:

• Where they are
• Who you are
• What happened
• Whether emergency help has been called
• Whether they appear to be injured

Do not ask many questions at once. Give them time to recover.

Allow Safe Rest

Keep the person on their side until they are fully awake and breathing normally.

Do not give food, drink, pills, or oral medication until they:

• Are completely alert
• Can sit safely
• Can speak and respond normally
• Can swallow without difficulty

When they are fully recovered, offer to contact a family member, friend, caregiver, or emergency contact.

Do not allow the person to drive immediately after a seizure.

Check for Injuries

Once the movements have stopped, check for:

• Head injuries
• Bleeding
• Facial injuries
• A bitten tongue
• Shoulder pain
• Possible fractures or dislocations
• Burns
• Neck or back pain
• Difficulty moving
• Persistent weakness
• Breathing problems

Call 911 for significant injuries.

Do not attempt to push a dislocated joint back into place or straighten a deformed limb.

Seizures in Water

A seizure in a pool, bathtub, lake, ocean, or other body of water requires emergency attention.

Call 911.

When it is safe:

• Support the person’s head above water.
• Remove them from the water with appropriate assistance.
• Check breathing.
• Begin CPR if they are not breathing normally.
• Use an AED when available.
• Keep them warm.

The person needs medical evaluation even if they appear to recover because they may have inhaled water into the lungs.

Do not enter dangerous water without appropriate rescue training or equipment.

Seizures During Pregnancy

Call 911 for a seizure during pregnancy, even if the person has a history of epilepsy.

A seizure during pregnancy may be related to epilepsy, medication changes, eclampsia, or another serious condition.

Position the person on their side when possible, protect them from injury, and do not give food, drink, or oral medication.

Tell emergency responders:

• How far along the pregnancy may be
• Whether the person has epilepsy
• What medications they take
• Whether they have headache, vision changes, swelling, or abdominal pain
• How long the seizure lasted

Seizures and Diabetes

A seizure in someone with diabetes may be caused by dangerously low or high blood sugar or another condition.

Call 911.

If the person is unconscious or actively having a seizure:

• Do not give food or drink.
• Do not put glucose gel inside the mouth.
• Do not give insulin.
• Follow their diabetes emergency plan.
• Use prescribed glucagon only if available and you have been instructed how to use it.

Check blood sugar only when doing so does not delay emergency care or interfere with keeping the person safe.

Febrile Seizures in Children

Some young children experience seizures associated with fever. These are called febrile seizures.

During the seizure:

• Place the child on a safe surface.
• Move dangerous objects away.
• Protect the head.
• Turn the child onto one side when safe.
• Time the seizure.
• Do not restrain the child.
• Do not put anything in the child’s mouth.
• Do not place the child in a cold bath.
• Do not give medicine during active convulsions.

Call 911 when:

• It is the child’s first seizure.
• The seizure lasts five minutes or longer.
• Another seizure begins.
• The child has trouble breathing.
• The child does not begin recovering.
• The movements affect only one part or side of the body.
• The child is injured.
• You are uncertain what is happening.

Contact the child’s healthcare professional after any seizure associated with fever.

Nonconvulsive Seizures

Not every seizure causes falling or shaking.

A person may:

• Stare
• Stop responding
• Wander
• Repeat movements
• Smack their lips
• Pick at clothing
• Appear confused
• Attempt to remove clothing
• Walk toward danger
• Become agitated when stopped

To help:

• Stay with the person.
• Speak calmly.
• Guide them away from traffic, stairs, water, heat, and sharp objects.
• Do not grab or restrain them unless needed to prevent immediate injury.
• Block dangerous areas with your body when safe.
• Time the episode.
• Explain what happened as awareness returns.

Call 911 if the episode lasts five minutes or longer, repeats, causes an injury, is the person’s first known seizure, or differs from their usual pattern.

Focal Seizures With Awareness

During some seizures, the person remains aware but experiences:

• Jerking in one body part
• Tingling or numbness
• Changes in vision
• An unusual smell or taste
• Sudden fear
• A rising feeling in the stomach
• Difficulty speaking

Stay with the person and help them sit somewhere safe. Time the event and follow their seizure action plan.

Do not dismiss the symptoms simply because the person remains conscious.

Seizures After a Head Injury

Call 911 when a seizure follows:

• A fall
• A collision
• A sports injury
• A blow to the head
• A workplace accident
• Another traumatic event

Keep the person still after the seizure when a neck or spinal injury may be present. Avoid unnecessary movement and follow the dispatcher’s instructions.

Possible Poisoning or Overdose

A seizure may result from:

• Medication overdose
• Drug exposure
• Alcohol withdrawal
• Household chemicals
• Carbon monoxide
• Poisonous plants
• Other toxic substances

Call 911 for a seizure.

If a possible poisoning is involved, contact Poison Control in the United States at 1-800-222-1222, provided doing so does not delay emergency assistance.

Do not make the person vomit. Keep containers, medication bottles, labels, or other evidence available for emergency responders.

Recording What Happened

A description of the seizure can help the person’s healthcare professional.

Write down:

• The start and end time
• What the person was doing beforehand
• Whether there was a warning
• Which body part moved first
• Whether one or both sides were involved
• Whether the body stiffened
• Whether the person lost awareness
• Breathing and skin-color changes
• Eye and head position
• Any injury
• How the person behaved afterward
• How long recovery took
• Whether rescue medication was used

A short video may sometimes help a healthcare professional, but only when another capable person is already protecting the individual and recording does not delay care. Protect the person’s dignity and privacy.

When a Person With Known Epilepsy May Not Need 911

Not every seizure in someone with diagnosed epilepsy requires an ambulance.

Emergency services may not be necessary when:

• The seizure is typical for the person.
• It stops within the expected time.
• The person’s action plan does not require 911.
• No injury occurred.
• Breathing returns to normal.
• Recovery follows the person’s usual pattern.
• A responsible person can remain with them.

When uncertain, call 911. A seizure action plan should never prevent you from requesting help when something appears wrong.

Follow-Up After a Seizure

Someone who experiences a first seizure needs prompt medical evaluation.

A person with known epilepsy should contact their healthcare professional when:

• Seizures become more frequent.
• A seizure lasts longer than usual.
• The seizure pattern changes.
• Recovery takes longer.
• An injury occurs.
• New weakness, balance problems, or vision changes develop.
• Rescue medication is needed more often.
• Medication doses have been missed.
• Side effects are causing problems.
• Pregnancy is planned or possible.

Do not stop anti-seizure medication suddenly unless the prescribing professional directs you to do so. Abruptly stopping medication can trigger serious seizures.

Preparing for Future Seizures

Someone with epilepsy can prepare by:

• Creating a written seizure action plan
• Wearing medical identification
• Teaching family, friends, and coworkers seizure first aid
• Keeping rescue medication accessible
• Checking medication expiration dates
• Taking daily medication as prescribed
• Tracking seizure patterns
• Discussing driving and work restrictions
• Making the home safer
• Using appropriate supervision around water
• Avoiding activities where sudden loss of awareness would be especially dangerous

Caregivers should practice the emergency plan before a seizure occurs.

Common Mistakes to Avoid

Try not to:

• Hold the person down.
• Attempt to stop the movements.
• Put anything in the mouth.
• Attempt to hold the tongue.
• Give water, food, pills, or oral medication.
• Perform CPR during active seizure movements.
• Move the person unless they are in danger.
• Leave the person alone.
• Panic over normal post-seizure confusion.
• Allow the person to stand immediately.
• Assume every seizure involves shaking.
• Ignore a seizure lasting five minutes or longer.
• Ignore repeated seizures without recovery.
• Give rescue medication without a prescription, action plan, and training.
• Film the person instead of providing care.
• Make jokes or draw unnecessary attention to the event.

A Simple Seizure Checklist

When someone has a seizure:

1. Stay calm.
2. Begin timing.
3. Help the person to the ground if they are falling.
4. Clear dangerous objects.
5. Protect the head.
6. Loosen tight clothing around the neck.
7. Turn the person onto their side when safe.
8. Do not restrain them.
9. Do not put anything in their mouth.
10. Follow their seizure action plan.
11. Call 911 when the seizure lasts five minutes, repeats, causes injury, occurs in water, or involves another emergency warning sign.
12. Check breathing after the seizure stops.
13. Begin CPR if the person is not breathing normally.
14. Stay until the person is awake, safe, and appropriately supported.

Most seizures stop without emergency treatment. Your most important job is to stay with the person, protect them from injury, and recognize when the seizure has become a medical emergency.

Suggested Guides

• First Aid Basics: What Everyone Should Know
• Understanding CPR & How to Use an AED
• What to Do When Someone Faints
• Managing a Fever Safely
• Calling 911 & Explaining the Emergency
• Recognizing When a Problem Is an Emergency

Important Health & Safety Notice

The information in this guide is provided for general educational purposes only. Independence Answers is not a medical provider, and this content is not a substitute for professional medical advice, diagnosis, treatment, or supervision. Always follow the instructions of your doctor, pharmacist, or other qualified healthcare professional, especially if you have a medical condition, take medication, or are unsure whether an action is safe for you.

Do not ignore or delay seeking professional care because of something you read here. If you believe someone may be experiencing a serious or life-threatening emergency, call 911 or your local emergency number immediately.