First Aid


​Convulsive Seizures

When providing seizure first aid for generalized tonic-clonic (grand mal) seizures or partial seizures with secondary generalization, these are the key things to remember:
  • Keep calm and reassure other people who may be nearby.
  • Don’t hold the person down or try to stop his/her movements.
  • Time the seizure.
  • Clear the area around the person of anything hard or sharp.
  • Loosen ties or anything around the person’s neck that may make breathing difficult.
  • Put something flat and soft, like a folded jacket, under the person’s head.
  • Turn him/her gently onto one side. This will help keep his or her airway clear.
  • Do not try to force his or her mouth open with any hard implement or with fingers. A person having a seizure CANNOT swallow his or her tongue. Efforts to hold the tongue down can injure teeth or the jaw.
  • Don’t attempt artificial respiration except in the unlikely event that a person does not start breathing again after the seizure has stopped.
  • Stay with the person until the seizure ends naturally.
  • Be friendly and reassuring as consciousness returns.
  • Offer to call a taxi, friend or relative to help the person get home if he or she seems confused or unable to get home by himself.
An uncomplicated generalized tonic-clonic (grand mal) seizure in someone who has epilepsy is not a medical emergency, even though it looks like one. It stops naturally after a few minutes without ill effects. The average person is able to continue about his/her business after a rest period, and may need only limited assistance or no assistance at all in getting home. In other circumstances, an ambulance might need to be called.

When to Seek Emergency Treatment:  If repeated seizures occur, or if a single seizure lasts longer than five minutes, the person should be taken to a medical facility immediately. Prolonged or repeated seizures are known as status epilepticus (nonstop seizures) and require emergency medical treatment.


​Nonconvulsive Seizures

You don’t have to do anything if a person has brief periods of staring or shaking, unless they are nonstop. If someone has the kind of seizure that produces a dazed state and automatic behavior (behavior performed without conscious knowledge or under conscious control), the best thing to do is:
  • Watch the person carefully and explain to others what is happening.
  • Speak quietly and calmly in a friendly way.
  • Gently guide the person away from any danger, such as a steep flight of steps, a busy highway or a hot stove. However, don’t grab the person, or try to move them forcefully unless some immediate danger threatens.
  • Stay with the person until they are fully conscious again and you can offer to help them get home.

Head Injury During a Seizure

If the person hits his or her head while falling, his or her post-seizure condition should be carefully monitored. Although sleepiness and confusion are normal postictal (post-seizure) problems, it should always be possible to wake the person without difficulty after a few minutes have passed. A person who fails to return to consciousness after a seizure needs further medical assessment. If a head injury is a possibility, the person should be closely observed for:
  • Difficulty in maintaining consciousness
  • Vomiting
  • Vision problems
  • Excessive sleepiness two or more hours after the seizure
  • Immediate medical attention is required if any of the above signs are observed, or if the patient has:
    • A persistent headache after a rest period
    • Unconsciousness with failure to respond
    • Unequal pupil size or excessively dilated pupils
    • Uncharacteristically weak limbs
    • Concern that they have suffered a cervical spine (neck) injury

When to Call an Ambulance

An ambulance should be called if:
  • The seizure happened in water.
  • The person is not wearing any medical ID, and there is no way of knowing whether or not the seizure is caused by epilepsy.
  • The person is pregnant, injured or diabetic.
  • The seizure continues for more than five minutes.
  • A second seizure starts shortly after the first has ended.
  • Consciousness does not start to return after the shaking/convulsing has stopped.
  • If the ambulance arrives after the person’s consciousness has returned, the person should be asked whether the seizure was associated with epilepsy and whether emergency care is needed.

Safety Tips

These safety tips should reduce the chance of injury during a seizure:
  • In the bathtub/shower, consider using a seat with a safety strap.
  • When showering, set the water temperature low so you won’t be scalded if you lose consciousness while the water is running.
  • Carpet the floors with heavy pile and thick under-padding.
  • Pad sharp corners of tables and other furniture.
  • Use plastic dishes and cups with lids to prevent cuts or burns from spills.
  • When you use the stove, use the back burners.
  • Wear rubber gloves when handling knives or washing dishes and glassware in the sink.
  • Stand back from the road when waiting for a bus and stand back from the platform edge when taking the subway or train.
  • Wear a life vest when you are on or close to water.
Here is an excellent video of some first aid for seizures "best practices"!