If someone near you is having a seizure, the most important things you can do are stay with them, move dangerous objects away, and 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 is to keep the person safe until it’s over, then stay with them as they recover.
The Three Core Steps: Stay, Safe, Side
The CDC frames seizure first aid around three words: Stay, Safe, Side. These apply to virtually every type of seizure.
- Stay with the person for the entire seizure and the recovery period afterward.
- Safe means clearing the area around them. Push away furniture, sharp objects, anything they could hit during involuntary movements.
- Side refers to gently rolling the person onto their side with their mouth pointing toward the ground. This keeps the airway clear and prevents choking if they vomit.
That’s the foundation. If you remember nothing else, those three actions cover the essentials.
Step-by-Step for a Full-Body Seizure
When someone has a generalized tonic-clonic seizure (the type most people picture, with stiffening and shaking), the steps go a bit further:
- Ease them to the ground if they’re standing or sitting and appear to be falling. Don’t try to catch them midair; guide them down gently.
- Clear the space around them so they can’t strike furniture, walls, or other objects.
- Put something soft and flat under their head, like a folded jacket or sweater, to protect it from the hard floor.
- Remove their eyeglasses if they’re wearing any.
- Loosen anything around the neck that could restrict breathing: ties, scarves, tight collars, lanyards.
- Roll them gently onto their side with their mouth pointing downward so fluid can drain.
- Time the seizure. Pull out your phone and note when the shaking started. If it lasts longer than 5 minutes, call 911 immediately.
Timing matters more than people realize. In the moment, 90 seconds can feel like 10 minutes. Checking a clock gives you an objective measure and critical information for paramedics if they’re needed.
What Not to Do
Several common instincts during a seizure are actually dangerous. Do not put anything in the person’s mouth. People do not swallow their tongues during seizures, and forcing an object between clenched teeth can break teeth, injure the jaw, or cause choking. Do not hold the person down or try to stop their movements. Restraining someone mid-seizure won’t shorten it, and you risk injuring them or yourself. Do not attempt CPR while the seizure is active. The person’s body is moving involuntarily, not because their heart has stopped. Do not offer water or food until they’re fully alert.
Seizures That Don’t Involve Shaking
Not all seizures look dramatic. Some cause the person to stare blankly, smack their lips, fidget with their clothing, or wander aimlessly while appearing confused. These focal seizures with impaired awareness don’t typically require the same physical interventions, but the same core principles apply: stay with them, gently guide them away from hazards like traffic or stairs, and don’t restrain them or shout at them. Speak calmly and wait for it to pass. The person likely won’t remember what happened and may need you to explain it afterward.
After the Seizure Ends
The period right after a seizure is called the postictal phase, and it can be just as disorienting as the seizure itself. The person may be confused, drowsy, embarrassed, or even agitated. Some people have trouble speaking for several minutes. Others fall into a deep sleep.
If they’re lying on their back, roll them into the recovery position: with them flat on their back, take the arm closest to you and extend it out at a right angle. Fold their other arm so the back of that hand rests against the cheek nearest you. Bend their far knee, then gently pull that knee toward you to roll them onto their side. Their head should rest on their folded hand, and their bent leg keeps them stable. Tilt their head back slightly and lift the chin to open the airway, then check that nothing is blocking their mouth.
Stay with them and talk calmly. Tell them who you are, where they are, and what happened. Keep your voice steady and reassuring. Many people feel frightened or disoriented after a seizure, and a calm presence makes a real difference. Don’t crowd them or let a group of bystanders gather around, as waking up to a ring of staring faces adds to the confusion. If you’re in a public place, ask onlookers to give them space.
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. A seizure that won’t stop on its own is a medical emergency called status epilepticus and can cause brain damage.
- The person doesn’t regain consciousness or remains confused for a prolonged period after the shaking stops.
- A second seizure follows shortly after the first.
- The person is injured during the seizure.
- The seizure happens in water (more on this below).
- The person is pregnant.
- It’s the person’s first known seizure.
- The person has diabetes, heart disease, or another serious medical condition.
- The person is not breathing normally after the seizure ends.
If you’re unsure whether to call, call. Paramedics would rather respond to a seizure that turns out to be uncomplicated than arrive too late for one that isn’t.
Seizures in Water
A seizure in a pool, bathtub, lake, or ocean is always an emergency. The immediate risk is drowning. Support the person’s 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 they’re not, begin CPR right away and call for an ambulance. Even if the person seems fully recovered 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.
If the Person Has a Seizure Action Plan
Some people with epilepsy carry medical ID bracelets, wallet cards, or phone alerts with specific instructions. These may include prescribed rescue medications that a trained caregiver can administer, or they may note that the person’s seizures are well-controlled and don’t require a 911 call under a certain duration. If you find this kind of information, follow it. It was created with their doctor and reflects their specific medical history. If you don’t find any plan, follow the general first aid steps above.