Dos and Don'ts of Seizure First Aid - Houston Pediatric Epilepsy Care

Dos and Don'ts of Seizure First Aid

Would you know what to do if you witnessed someone having a seizure? These dos and don'ts could help you save a person's life.

By Alice Martin 

Medically reviewed by Lindsey Marcellin, MD, MPH

A seizure can be terrifying to witness, especially if you aren’t prepared to help. Doctors say that it’s a good idea for everyone to know how to react with the right first aid, particularly if a family member, friend, or co-worker has epilepsy.

How to Recognize a Seizure

When 10-year-old Will Bibbo had his first seizure a year ago, his mother, Margaret, was understandably frightened. “It was the middle of the night, and he started making gurgling sounds, like he was choking," she recalls. "He was foaming at the mouth, and his body was rigid.” Not knowing what else to do, the Atlanta mother called 911.

“With the most intense seizures, a person will make choking sounds, go stiff, lose consciousness, and jerk their arms and legs," says Joshua Rotenberg, MD, a pediatric neurologist at Memorial Hermann Memorial City Medical Center in Houston. "It can be very dramatic and very hard to miss.”

The most important thing you can do if you witness someone having a seizure, he says, is to stay calm. About 80 percent of seizures are over in three minutes — which makes it all the more important to act quickly and effectively. These basic dos and don’ts can help.

Epilepsy First Aid: Dos

• Keep a cool head under pressure. Focus on your goal — to keep the person safe until the seizure stops.
• Move things out of the way. Remove the individual’s eyeglasses, tie, or scarf, if you can. Also look out for any hard or sharp objects nearby that might cause injury. If the person is seated, try to gently pull him onto a flat surface so he does not fall.
• Place something soft and flat under the head. A pillow, a folded jacket, or a sweater offers protection.
• Try to turn the person on her side. This clears the airways by allowing saliva to flow out of the mouth.
• Time the seizure. Note the time when the seizure begins. An epileptic seizure will generally last only two to three minutes.
• Check for medical identification. Someone with epilepsy should be wearing a medical bracelet or card containing emergency contact information, what medications he takes, and any drug allergies.
• Call 911 — if you don’t know the person; if it is the person’s first seizure; if the person is pregnant, has diabetes, or is injured; or if the seizure lasts longer than five minutes.
• Control the crowd. If you are in a public place, clear a path for emergency medical workers and tell onlookers to move along.

Epilepsy First Aid: Don’ts

• Restrain the person. You could injure the person or get injured yourself.
• Offer food or drink. Even a sip of water could cause choking.
• Put anything in the person’s mouth. It is not true that people having an epileptic seizure can swallow their tongue. Attempting to put an object in the individual’s mouth could be dangerous to you and to him.
• Perform CPR. Don’t attempt cardio pulmonary respiration or artificial respiration unless the person is not breathing when the seizure has stopped.

Epilepsy First Aid: After the Seizure

Most people, like Margaret’s son Will, don’t remember their seizures — but that doesn’t make the experience any less distressing. “A seizure can be traumatic and embarrassing,” Rotenberg says. “People may wake up to find that they have lost control of their urine or vomited. It’s important to respect them.”

The person may also be confused and combative or try to run away, but more likely, he or she will be very tired and want to sleep. Stay as long as you can and offer reassurance.

Epilepsy First Aid: Practice Makes Perfect

If a loved one has epilepsy, it’s a good idea to come up with a “seizure action plan.” Every family member should know — and practice — what to do.

Bibbo’s twin sister has witnessed his seizures and heard his choking sounds in the night. But now she knows how to stay calm and help her brother. “It’s still a shock every time Will has a seizure,” says his mother, “but it gets easier because we are prepared.”

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