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How to Help Someone During a Seizure: A Step-by-Step Guide

Seizures can be frightening, both for the person experiencing them and for those around them. Whether it’s your first time witnessing a seizure or you’ve had experience in the past, knowing how to respond calmly and appropriately can make all the difference in ensuring the person’s safety.

Seizures are caused by sudden, abnormal electrical activity in the brain. They can vary in severity and duration, but regardless of the type of seizure, certain first aid procedures are essential to minimizing risks and providing immediate assistance.

In this article, we’ll cover the types of seizures, how to recognize them, and the best steps you can take to help someone during a seizure. By understanding what to do (and not to do), you can confidently provide the right support.

Authored by the MD Searchlight Team

Source:

Author: Heather Keppler

1. Understanding Seizures: Types and Symptoms

Seizures are categorized into two main types: generalized seizures and focal seizures. While both involve a sudden surge of electrical activity in the brain, the symptoms and impact can vary.

Generalized Seizures

These seizures affect both sides of the brain and can cause loss of consciousness. They are often characterized by:

  • Tonic-clonic seizures (Grand Mal seizures): This is the most widely recognized type of seizure, often involving a loss of consciousness, followed by muscle stiffness (tonic phase), and then rhythmic jerking movements (clonic phase).
  • Absence seizures (Petit Mal seizures): These involve brief periods of staring or unresponsiveness, often without the convulsions seen in tonic-clonic seizures.

Focal Seizures

Also known as partial seizures, these occur when abnormal electrical activity is limited to one part of the brain. Focal seizures can be simple or complex:

  • Simple focal seizures: These may cause unusual sensations, such as strange smells, visual disturbances, or tingling sensations in a specific part of the body. The person remains conscious during the seizure.
  • Complex focal seizures: These may cause confusion or loss of awareness and may include automatic movements such as lip-smacking or hand-wringing.

Seizures can last from a few seconds to several minutes. However, seizures that last longer than 5 minutes or follow one another rapidly may be considered a medical emergency (status epilepticus).

2. How to Recognize the Signs of a Seizure

Seizures often have distinct signs that can help you recognize them quickly. The most common symptoms include:

  • Staring spells or loss of consciousness
  • Convulsions or uncontrollable jerking movements
  • Twitching or stiffening of muscles
  • Breathing irregularities (such as difficulty breathing or excessive salivation)
  • Unusual sensations or altered awareness

If you’re unsure whether someone is having a seizure, it’s important to observe their behavior closely. Some people may simply zone out or appear disoriented, while others may have more dramatic convulsions. Understanding the different symptoms and behaviors can help you respond appropriately.

3. How to Help Someone During a Seizure: Step-by-Step First Aid

If you witness someone having a seizure, staying calm and following these first aid steps can help reduce the risk of injury and provide the best care.

Step 1: Stay Calm and Stay With the Person

It’s essential to remain calm and not panic, both for your own sake and the person having the seizure. Reassure yourself that, most of the time, seizures are temporary and will pass within a few minutes. If the person is alone, stay with them to provide support and prevent injury.

Step 2: Ensure the Person’s Safety

Make sure the person is in a safe environment. If possible, move objects away from them to prevent injury. Clear any furniture, sharp objects, or hard surfaces that could cause harm during the seizure. If the person is near a busy road, gently guide them to a safer location.

If they are standing or walking, help them sit or lie down in a safe position. This can help prevent falls or accidents that could occur if they lose their balance.

Step 3: Protect the Head

If the person is on the ground, gently place something soft under their head—like a folded jacket or a cushion. Avoid trying to hold their head down or restrain their movements. Let the seizure run its course.

Step 4: Time the Seizure

Use a watch, phone, or timer to track the duration of the seizure. This is important information for medical professionals. Most seizures last less than 5 minutes. If the seizure lasts longer than 5 minutes, or if another seizure follows immediately after, call emergency services.

Step 5: Do Not Put Anything in Their Mouth

Despite the common myth, do not attempt to put anything in the person’s mouth. This can cause choking, dental injuries, or even cause the person to accidentally bite you. Instead, focus on ensuring their airway is clear and that they’re safe.

If the person is drooling or has foam around their mouth, gently turn their head to the side to allow any fluids to drain away. This can also help prevent choking.

Step 6: Be Patient and Provide Comfort After the Seizure

Once the seizure ends, the person may feel disoriented, exhausted, or confused. Be patient, as this postictal state (the recovery period after a seizure) can last from a few minutes to an hour. Offer reassurance and give them time to recover. Help them to a safe, comfortable position, and allow them to rest.

If the person is awake and coherent after the seizure, ask them if they need medical attention. They may prefer to rest and recover privately.

4. When to Seek Medical Help

While most seizures are not life-threatening, there are certain situations where you should seek medical attention immediately. Call 911 or your local emergency services if:

  • The seizure lasts more than 5 minutes.
  • The person has a second seizure immediately after the first.
  • The person is injured during the seizure.
  • The person has difficulty breathing or does not regain consciousness after the seizure.
  • The person has a seizure in water (e.g., in a pool or bathtub).
  • This is the person’s first seizure.

Additional Considerations

If the person has a known history of seizures and their seizures are typically brief and self-resolving, you may not need to seek emergency medical care. However, always err on the side of caution and contact a healthcare professional if you are unsure.

5. What Not to Do During a Seizure

When helping someone during a seizure, there are certain actions to avoid, as they can make the situation worse or cause harm to the person.

What Not to Do:

  • Do not restrain their movements: Trying to hold the person down or stop their movements can lead to injury or make the seizure last longer.
  • Do not put anything in their mouth: This is a dangerous misconception. Trying to force an object into someone’s mouth during a seizure can cause choking or oral injury.
  • Do not attempt to revive them immediately: After the seizure ends, don’t attempt to rouse them aggressively. Simply stay with them and offer support.

6. Conclusion: Helping Someone During a Seizure

Witnessing someone having a seizure can be alarming, but knowing what to do can make a significant difference in their safety and well-being. By staying calm, ensuring their environment is safe, protecting their head, and timing the seizure, you can provide critical support. Always call for medical help if the seizure lasts more than five minutes or if there are other signs of distress.

While seizures can be distressing, most are not life-threatening and do not require medical intervention beyond basic first aid. By following the proper steps, you can be a source of comfort and assistance for someone in need.

Important Reminder:

If you have concerns about seizures or epilepsy, or if you are unsure how to assist someone during a seizure, it is always beneficial to seek out more training, such as a first aid or CPR course, to better prepare for such situations.

References:

  1. Epilepsy Foundation – Seizure First Aid: Epilepsy Foundation First Aid Tips
  2. Mayo Clinic – Seizure Symptoms and Causes: Mayo Clinic Seizure Information
  3. WebMD – How to Help Someone During a Seizure: WebMD Seizure Aid
Frequently asked questions

If you see someone having a seizure, stay calm and ensure their safety. Clear the area of any potential hazards, such as furniture or sharp objects. Gently guide the person to the ground if they are standing to prevent injury, and protect their head by placing something soft underneath it. Avoid restraining their movements, and never put anything in their mouth. Time the duration of the seizure, and if it lasts longer than 5 minutes, call emergency services immediately.

Seizures can vary, but the most common signs include uncontrollable shaking or jerking movements (tonic-clonic seizure), loss of consciousness, staring spells, confusion, or sudden muscle stiffness. Sometimes, a person may experience unusual sensations, such as tingling or visual disturbances, before a seizure occurs. Watch for any sudden, unexplained changes in behavior or physical movements.

To protect someone during a seizure, ensure they are in a safe environment. Move objects away that could cause injury, such as sharp items or hard surfaces. If possible, guide the person to the ground to prevent falls. Place something soft under their head to avoid head injury. Do not try to restrain their movements, and avoid putting anything in their mouth. Stay with the person until the seizure ends and they are fully recovered.

No, you should never put anything in the person's mouth during a seizure. This could cause choking, tooth damage, or even injury to you. Contrary to popular belief, people do not bite their tongue off during seizures. Instead, focus on protecting their head and ensuring their airway remains clear by gently turning them onto their side if possible.

If the seizure lasts longer than 5 minutes, or if another seizure occurs immediately after the first one, you should call emergency services right away. Additionally, if the person is injured during the seizure, has trouble breathing, or does not regain consciousness after the seizure, seek immediate medical attention. Otherwise, most seizures end on their own within a few minutes.

Once the seizure ends, the person may be confused, disoriented, or extremely tired. Stay with them and offer reassurance, as they may feel scared or anxious. Allow them to rest in a safe position, and give them time to recover. If they are coherent, ask if they need medical attention. Never try to revive someone aggressively right after the seizure—simply give them space to regain their bearings.

It’s generally not safe to drive someone to the hospital immediately after a seizure. The person may still be disoriented or confused, and driving could be dangerous for both of you. Call emergency services instead. If the person is well-known to have seizures and the seizure ends quickly, they may be able to travel safely once they fully recover, but it's still best to seek medical advice first.

You should seek medical help if: The seizure lasts more than 5 minutes. The person has another seizure immediately after the first. The person is injured during the seizure. The person has difficulty breathing or doesn't regain consciousness after the seizure. This is the person’s first seizure, or if they have a change in seizure pattern or frequency. In these cases, it’s important to call emergency services right away.
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