What to do
- Stay calm and stay with the person. Note the time the seizure starts.
- Move hard or sharp things away. Move the person only if they are in danger, for example near a busy road or a hot stove.
- If they are on the ground, put something soft and flat, such as a folded jacket, under their head. Take off their glasses.
- Loosen anything tight around the neck, such as a collar or tie.
- Let the seizure run its course. Do not try to stop the movements, and put nothing in their mouth.
- When the jerking stops, turn them onto their side (the recovery position), so that saliva or vomit can drain from the mouth.
- Stay with them and speak calmly until they are fully alert. They may be confused or sleepy for a while. Tell them what happened.
- Give nothing to eat or drink until they have fully recovered. Help them get home safely, and tell them to see a doctor.
What not to do:
- Do not hold the person down or try to stop the movements.
- Do not put anything in the mouth, not even your fingers, and do not try to hold the tongue.
- Do not give mouth-to-mouth breaths during the seizure. Breathing usually starts again by itself.
- Do not start CPR unless the seizure has clearly stopped and the person is not breathing.
- Do not leave the person alone, or move them unless they are in danger.
When to call for an ambulance
Someone who has epilepsy does not need an ambulance for every seizure. If they have a care plan agreed with their doctors, and you know what it says, follow it. Many people with epilepsy wear a bracelet or carry a card that says so.
After the seizure
A doctor will want to know what happened. If you can, note how long it lasted, what the person was doing beforehand, which parts of the body stiffened or jerked, any change in colour or breathing, and how they were afterwards. Anyone who has a seizure for the first time should see a doctor, even if they seem to recover completely.
Seizures with fever in young children
A febrile seizure is a seizure that comes with a fever in a young child. It usually affects children between about 6 months and 6 years of age, and usually lasts 2 to 3 minutes. It is frightening to watch, but the first aid is the same: note the time, protect the head and clear away hard things, and put nothing in the mouth. Do not hold the child still, undress them or sponge them with cold water.
When the shaking stops, place the child in the recovery position. Call for an ambulance, or go straight to a hospital emergency department, if it is the child's first seizure, it lasts longer than 5 minutes, the child has trouble breathing, only one side of the body is stiff or twitching, the child is sleepier than usual an hour after it ends, or there is more than one seizure in 24 hours. After a first febrile seizure, a child should be checked in hospital.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Put a spoon, stick, cloth or finger in the mouth so that the person does not bite or swallow the tongue.”What is true?
Fact
Nothing should go in the mouth during a seizure, because it can hurt the teeth and jaw. Do not try to hold the tongue either. Cushion the head, clear space and turn the person onto their side when the jerking stops.
Myth“Hold the person down tightly until the shaking stops.”What is true?
Fact
Do not hold the person down or try to stop the movements. It can injure them and you. Move hard things away and let the seizure run its course.
Myth“Make the person smell an onion or a shoe, or put an iron key in their hand, to bring them out of a fit.”What is true?
Fact
None of this is part of first aid advice, and it does not stop a seizure. Most seizures last only a few minutes. Keep the person safe, note the time and stay with them.
Myth“Give water, tea or a sweet to drink to bring the person round.”What is true?
Fact
Give nothing to eat or drink until the person is fully alert, because they could choke. Once they are alert, they can have a drink.
Common questions
How long does a seizure usually last?
Most seizures last just a few minutes. Time it from the start. If it lasts longer than 5 minutes, or longer than usual for that person, call for an ambulance.
Can a person swallow their tongue during a seizure?
First aid advice is to put nothing in the mouth and not to try to hold the tongue, because objects can hurt the teeth and jaw. Once the jerking stops, turning the person onto their side helps saliva or vomit to drain from the mouth.
Does someone who seems fine after a seizure still need to see a doctor?
Yes. A first seizure always needs medical help, even if the person seems to recover completely. Someone with epilepsy should tell their doctor about the seizure, and follow their care plan about when to get help.
Should I call for an ambulance every time someone with epilepsy has a seizure?
Not always. A person with epilepsy often has a care plan from their doctors that says when help is needed. Call if it is their first seizure, it lasts longer than 5 minutes or longer than usual for them, or any of the other warning signs are present.