The most important thing you can do when someone has a seizure is stay calm, keep them safe from injury, and time it. Most seizures end on their own within one to three minutes and don’t require emergency medical care. Your job isn’t to stop the seizure. It’s to protect the person until it passes, then help them recover.
What to Do During the Seizure
If someone near you starts having a convulsive seizure (their body stiffens and shakes), act quickly but don’t panic. Lower them to the ground if they’re standing, and clear away anything hard or sharp they could hit, like furniture, glasses, or sharp objects. Place something soft under their head, such as a folded jacket or sweater, to protect it from striking the floor.
Turn them gently onto their side. This keeps their airway clear by letting saliva or vomit drain out of the mouth instead of pooling in the back of the throat. If you can, loosen anything tight around their neck like a tie or buttoned collar.
Start timing the seizure as soon as you notice it. Pull out your phone and note the time. This single detail matters more than almost anything else you do, because it determines whether you need to call 911.
What Not to Do
Never put anything in the person’s mouth. Not a wallet, not a spoon, not your fingers. This is one of the most persistent myths about seizure first aid, and it causes real harm: broken teeth, cut gums, and injuries to the person trying to help. It’s physically impossible to swallow your tongue during a seizure. The tongue may move or be bitten, but forcing an object between clenched jaws makes things worse, not better.
Don’t hold the person down or try to restrain their movements. Seizures involve involuntary, powerful muscle contractions, and fighting against them can cause sprains, dislocations, or fractures. Don’t attempt CPR during the seizure. The person’s breathing may look irregular or pause briefly, but it will typically resume on its own once the seizure ends. Don’t offer water or food until they’re fully alert.
When to Call 911
Call 911 if the seizure lasts longer than 5 minutes. This is the threshold where a seizure becomes a medical emergency. A seizure lasting this long is unlikely to stop on its own and can cause brain damage without treatment.
You should also call 911 if:
- The person has never had a seizure before (or you don’t know their history)
- They have a second seizure shortly after the first
- They don’t regain consciousness or start breathing normally after the seizure stops
- The person is pregnant, has diabetes, or was injured during the seizure
- The seizure happened in water
How to Place Someone in the Recovery Position
Once the seizure stops, or during it if you can do so safely, roll the person onto their side. The NHS describes a specific technique that works well: kneel beside them and extend the arm closest to you straight out at a right angle, palm facing up. Take their other hand and fold it so the back of that hand rests against the cheek nearest you. Then bend their far knee to a right angle and use it as a lever to gently roll them toward you. Their bent arm supports their head, and the position keeps them stable so they won’t roll onto their face.
Once they’re on their side, gently tilt their head back slightly and lift their chin to open the airway. Check that nothing is blocking their mouth. Stay with them.
Seizures That Don’t Involve Convulsions
Not all seizures look like the dramatic full-body shaking you see in movies. Some seizures cause a person to stare blankly, appear confused, wander, pick at their clothes, or make repetitive movements like lip smacking or hand rubbing. The person usually can’t respond to you normally during these episodes.
For these seizures, your role is to gently guide the person away from danger. If they’re near traffic, a staircase, or deep water, calmly steer them to a safe spot. Speak in a calm, reassuring voice. Don’t grab them or shout. Don’t try to shake them out of it. These seizures typically pass within a couple of minutes, and the person may not remember what happened.
Seizures in Water
A seizure in a pool, bathtub, or open water is especially dangerous because drowning can happen in seconds. If you see someone having a seizure in water, your priority is keeping their face above the surface. For a convulsive seizure, try to support their head out of the water and call for a lifeguard or bystander to help you move them to shallow water or get them out entirely.
Once they’re out of the water, cushion their head, don’t restrain them, and place them in the recovery position when the seizure ends. Keep them warm, since their body temperature can drop quickly when wet. Stay with them until they’ve fully recovered.
What Happens After the Seizure Ends
The period immediately after a seizure is called the postictal phase, and it can be almost as disorienting as the seizure itself. The person may experience confusion, exhaustion, headache, muscle soreness, difficulty speaking, or memory loss. Some people feel anxious, agitated, or emotionally overwhelmed. Loss of bladder control during or after a seizure is also common, and can be a source of embarrassment, so handle it with discretion.
This recovery phase lasts anywhere from a few minutes to about 30 minutes on average, though more severe seizures can leave someone in a foggy state for hours or, rarely, days. During this time, stay with the person. Speak calmly. Tell them what happened, where they are, and that they’re safe. Don’t leave them alone until they’re fully alert and oriented. Many people feel deeply exhausted after a seizure and may need to rest or sleep.
If the Person Has a Seizure Action Plan
People with diagnosed epilepsy sometimes carry medical ID bracelets or wallet cards, or their family members know their seizure action plan. This plan, created with their doctor, may include a prescribed rescue medication that a trained caregiver can administer if a seizure lasts beyond a certain time. These medications are prescribed for a specific individual and come with clear instructions on when and how to use them.
If you’re a caregiver, family member, or school nurse responsible for someone with epilepsy, make sure you know their plan before an emergency happens. If you’re a bystander helping a stranger, check for a medical ID bracelet or necklace once the seizure ends, as this can give paramedics important information about the person’s condition and medications.