If someone near you is having a seizure, the most important things you can do are stay calm, keep them safe from injury, and time how long it lasts. 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.
During the Seizure: Step by Step
Start timing the seizure as soon as you notice it. This single detail matters more than almost anything else you can do, because a seizure lasting longer than 5 minutes is a medical emergency that requires a 911 call. Use your phone’s stopwatch if you can.
While the seizure is happening:
- Clear the area. Move chairs, sharp objects, or anything nearby that could cause injury. If the person is standing, help ease them to the ground.
- Place something soft under their head if they’re on a hard surface. A folded jacket or sweater works.
- Turn them gently onto their side with their mouth pointing toward the ground. This keeps their airway clear and prevents choking if they vomit.
- Loosen tight clothing around the neck or head.
- Check for a medical bracelet on their wrist or neck. It may list their condition, medications, and emergency contacts.
- Stay with them. Don’t leave until the seizure ends and they’re fully alert.
What Not to Do
Do not put anything in the person’s mouth. This is one of the most persistent myths about seizures. It looks like the person might swallow their tongue, but the tongue is a strong muscle firmly attached to the floor of the mouth. It cannot be swallowed. Forcing an object between clenched teeth can break teeth, injure the jaw, or hurt your fingers.
Do not hold the person down or try to restrain their movements. Seizure-related muscle contractions are powerful, and fighting against them can cause injury to both of you. Do not attempt CPR during the seizure. The person’s breathing may look irregular or pause briefly, but it typically returns to normal once the seizure stops.
Not All Seizures Look the Same
The dramatic, full-body convulsions most people picture are only one type. Some seizures cause a person to stare blankly into space, act confused, wander aimlessly, or make repetitive movements like lip smacking or hand rubbing. These episodes can last anywhere from a few seconds to a couple of minutes.
The first aid approach is the same: stay with the person, gently guide them away from hazards if they’re walking, speak calmly, and don’t restrain them. They may not respond to you or even realize anything is happening. That’s normal. Wait for the episode to pass, then help orient them.
After the Seizure Ends
The period immediately after a seizure can be just as disorienting as the seizure itself. The person may feel confused, exhausted, or emotional. They might not remember what happened or even recognize where they are. This recovery phase can last anywhere from a few minutes to over an hour.
Help them sit somewhere safe and comfortable. Ask simple questions: Do you know your name? Do you know where you are? What time of day is it? If they can’t answer, that’s okay. Calmly tell them the information instead. Say something like, “You’re at the grocery store. You had a seizure. You’re safe now.” Keep it simple and matter-of-fact.
Don’t leave them alone until they can answer those basic orientation questions, they’re breathing normally, they can communicate clearly, and you’re able to wake them if they fall asleep. Once they’re alert, offer to call someone who can help them get home. If they don’t remember the details of what happened, write it down for them so they can share it with their doctor later.
When to Call 911
Most seizures don’t require an ambulance, but certain situations do. Call 911 if:
- The seizure lasts longer than 5 minutes
- The person doesn’t regain consciousness or remains confused for a long time afterward
- A second seizure follows shortly after the first
- The person is injured during the seizure
- The seizure happens in water
- The person is pregnant, has diabetes, or has no known history of seizures
- The person has trouble breathing or their skin turns blue
A seizure lasting over 5 minutes is considered a medical emergency called status epilepticus. It requires immediate treatment because prolonged seizure activity can cause brain damage.
Seizures in Children With Fevers
Young children between 6 months and 5 years old sometimes have seizures triggered by a high fever. These febrile seizures are frightening to watch but are generally not dangerous. The steps are the same as for adults: place the child gently on the floor or ground, move objects away, turn them on their side, and loosen clothing around the head and neck.
Watch for signs of breathing problems, especially any bluish color in the face. Time the seizure. Get emergency care if it lasts longer than 5 minutes, involves only one part of the body rather than the whole body, causes breathing difficulties, or if the child isn’t responding normally afterward. A second seizure within 24 hours also warrants emergency evaluation.
Seizures in Water
A seizure in a pool, bathtub, or any body of water is immediately life-threatening because of the drowning risk. Support the person’s head and tilt their face so it stays above the surface. Get them out of the water as soon as the active convulsions allow it, then follow standard first aid on solid ground. Always call 911 for seizures that happen in water.
If the Person Has a Seizure Action Plan
People with known epilepsy sometimes carry a seizure action plan, which is a document outlining exactly what to do during their seizures, including whether and when to give a prescribed rescue medication. These medications are typically administered through the nose or cheek and are meant to be used by a caregiver when a seizure lasts longer than 5 minutes or when multiple seizures cluster together within a short period.
Some people with epilepsy also have an implanted device called a vagus nerve stimulator. If the person has one, you may find a small magnet on or near them. Swiping or holding the magnet over the generator on the upper left chest for one to two seconds sends an extra burst of stimulation that may shorten the seizure. You can repeat this up to three times, waiting at least 60 seconds between each use. If the seizure continues past 5 minutes despite three magnet applications, give the rescue medication if one is available.
What to Write Down for Their Doctor
If you witness someone’s seizure, the details you record can be enormously helpful to their medical team. Most people don’t remember their own seizures, so bystander observations are often the only source of information a doctor has.
Note the time the seizure started and how long it lasted. Describe what you saw: Did the whole body convulse, or just one arm or one side? Did they stare blankly? Were there warning signs beforehand, like dizziness or a strange expression? Did they lose consciousness? How long did it take them to become fully alert afterward? Any details about what they were doing right before the seizure can also be useful, along with possible triggers like missed sleep, illness, or flashing lights.