If someone near you is having a seizure, the most important things you can do are stay with them, move dangerous objects away, and gently turn them onto their side. 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 keep the person safe until it passes.
What to Do During a Convulsive Seizure
When someone drops to the ground shaking, your instinct may be to grab them or try to help them snap out of it. Resist that urge. Instead, follow these steps:
- Stay with them and start timing. Look at a clock or your phone. How long the seizure lasts is one of the most important pieces of information you can provide to paramedics or the person’s doctor.
- Clear the area. Push away furniture, sharp objects, or anything they could hit during convulsions. If they’re near a staircase or the edge of a platform, guide them away if you safely can. Place something soft, like a folded jacket, under their head.
- Turn them onto their side. Once the intense shaking slows, roll the person onto their side with their face angled slightly downward. This keeps their airway clear so saliva or vomit can drain instead of blocking their breathing.
- Loosen tight clothing. Unbutton a collar or loosen a tie if anything is tight around the neck.
- Stay calm and speak gently. When the seizure ends, the person will likely be confused, exhausted, or disoriented. Let them know where they are and what happened. Stay with them until they’re fully alert.
What You Should Never Do
Two of the most common instincts people have during a seizure are also the most dangerous: holding the person down and putting something in their mouth. Restraining someone mid-seizure can cause muscle tears, joint injuries, or fractures. It also won’t shorten the seizure.
Putting a spoon, wallet, or any object between their teeth is based on the myth that a person can swallow their tongue during a seizure. That’s physically impossible. Forcing something into their mouth can crack teeth, cut gums, or injure your fingers. Don’t offer water or food until the person is fully conscious and alert, either, since their swallowing reflexes may not be working normally right away.
When to Call 911
Most seizures resolve on their own, but certain situations are genuine emergencies. Call 911 if:
- The seizure lasts longer than 5 minutes
- A second seizure follows shortly after the first
- The person has trouble breathing or doesn’t wake up after the seizure ends
- They were injured during the seizure
- The seizure happened in water
- It’s their first seizure ever
- They are pregnant
- They have diabetes and have lost consciousness
The 5-minute mark matters because prolonged seizure activity can cause permanent brain injury and becomes harder to stop with medication the longer it continues. Clinicians treat any seizure lasting 5 minutes or more as a medical emergency. If you’re unsure how long it’s been, err on the side of calling.
Seizures That Don’t Involve Convulsions
Not every seizure looks like what you see in movies. Some seizures cause a person to stare blankly, smack their lips, pick at their clothes, or wander around looking confused. They may not respond when you talk to them or may repeat the same phrase over and over. These episodes can be easy to miss or mistake for intoxication or a mental health crisis.
Your approach is similar but gentler. Stay nearby, speak calmly, and guide the person away from hazards like traffic, stairs, or hot stoves. Don’t grab or restrain them. Don’t shout or shake them to “snap them out of it.” The episode will pass, and they’ll likely have no memory of it. Once they’re aware again, explain what happened and help them get oriented. The same 911 criteria apply: if it lasts beyond 5 minutes, if they can’t breathe normally, or if it’s a first-time event, call for help.
If a Seizure Happens in Water
Water turns any seizure into a drowning risk. If someone seizes in a pool, bathtub, or any body of water, support their head above the surface with their face tilted upward and get them out of the water as quickly as possible. Once they’re on solid ground, check whether they’re breathing. If not, begin CPR immediately and call 911.
Even if the person seems completely fine afterward, they need a medical evaluation. Inhaling even a small amount of water can damage the lungs or heart in ways that aren’t immediately obvious.
Seizures in Children With Fever
Young children sometimes have seizures triggered by a rapid spike in body temperature, often above 101°F (38.3°C). These febrile seizures are frightening to watch but are usually harmless and end within a couple of minutes. The same rules apply: place the child on their side on a safe surface, don’t put anything in their mouth, and time the episode.
Don’t try to cool the child with a cold bath during the seizure. Once it’s over, you can use a lukewarm cloth and remove extra layers of clothing. If your child has a history of febrile seizures, their doctor may have prescribed a rescue medication to use at home, typically given through the nose or rectally. Follow the instructions you were given for when and how to use it. If it’s your child’s first febrile seizure, call their pediatrician or go to the emergency room even if the episode was brief.
How to Place Someone in the Recovery Position
Rolling someone onto their side sounds simple, but a few details make it safer. Start with the person flat on their back. Take the arm closest to you and position it out to the side in an L-shape, with their hand roughly level with their head, as if they’re waving. Then take their far hand and bring it across their body so the back of that hand rests against the cheek nearest to you. Use your other hand to bend their far knee, then gently roll them toward you using that knee as leverage. Their head should end up resting on the hand you placed against their cheek, with their face angled slightly downward so fluids can drain. Tilt them so the head is just slightly lower than the stomach.
Keep the back of your hand near their mouth so you can feel whether they’re breathing. Stay in this position with them until they wake up or paramedics arrive.
What Happens After a Seizure
The minutes following a seizure are called the recovery phase, and they can look almost as alarming as the seizure itself. The person may be deeply confused, drowsy, or agitated. Some people cry, feel nauseous, or have a headache. Others have temporary weakness on one side of their body. This is all normal and typically clears within 5 to 30 minutes, though some people feel “off” for hours.
During this time, keep your voice calm and your instructions simple. Don’t overwhelm them with questions. Let them rest if they need to. If you witnessed the seizure, write down what you saw: what time it started, how long it lasted, what parts of the body were involved, and whether the person was conscious. This information is extremely useful for their doctor later on.