Most seizures end on their own within one to three minutes, and the single most important thing you can do is keep the person safe until it stops. Whether you’re helping someone else or preparing for your own seizures, the priorities are the same: prevent injury, protect breathing, and know when to call 911.
During a Convulsive Seizure
When someone drops to the ground and their body stiffens or shakes, your job is simple: clear the space and let the seizure run its course. Move chairs, tables, or anything hard away from them. If possible, ease them to the ground and place something soft, like a folded jacket, under their head. Note the time so you know how long the seizure lasts.
Gently roll the person onto their side. This keeps their airway clear by letting saliva or any fluid drain from the mouth rather than pooling in the throat. Loosen anything tight around the neck, like a tie or buttoned collar. Stay with them the entire time and speak calmly, even if they can’t respond.
What Not to Do
It is anatomically impossible to swallow your tongue during a seizure. Despite this, a persistent myth tells people to put a wallet, spoon, or fingers into a seizing person’s mouth. Every modern expert guideline advises against this. Forcing an object between clenched teeth can break teeth, cut gums, injure the jaw, or hurt your own fingers.
Do not hold the person down or try to stop their movements. Restraining someone mid-seizure won’t shorten it and can cause muscle tears, joint injuries, or fractures. Don’t offer water or food until the person is fully awake and alert. And don’t attempt CPR while the seizure is still happening. Breathing may look irregular or pause briefly during a convulsion, but it almost always resumes once the shaking stops.
When a Seizure Isn’t Convulsions
Not all seizures involve falling and shaking. Some cause a blank stare, confusion, repetitive movements like lip-smacking or hand-rubbing, or an inability to respond to questions. These episodes can look mild, but the person often has no awareness of what’s happening around them.
Your approach is similar: stay close, guide them gently away from hazards like traffic, stairs, or hot surfaces, and don’t grab or restrain them. Talk in a calm, simple voice. These seizures typically last under two minutes. Afterward, the person may be disoriented and not remember what happened. Stay with them until they’re fully alert and can tell you where they are and what they were doing.
When to Call 911
A seizure lasting longer than five minutes is a medical emergency. Prolonged or repeated seizures without a return to consciousness can cause irreversible brain injury, and the person needs emergency treatment as fast as possible. Call 911 if:
- The seizure lasts longer than five 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 happens in water
- It’s their first seizure ever
- The person is pregnant
- The person has diabetes and loses consciousness
If you’re unsure whether it’s been five minutes, err on the side of calling. Adrenaline distorts time perception, and what feels like thirty seconds may have already been several minutes.
Seizures in Water
Water makes any seizure life-threatening. If someone seizes in a pool, bathtub, or any body of water, support their head above the surface with their face tilted upward. 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 right away and call 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.
After the Seizure Ends
The minutes following a seizure, sometimes called the recovery phase, can be just as disorienting as the seizure itself. The person may feel exhausted, confused, embarrassed, or emotional. They might not recognize where they are or who you are for several minutes.
Keep them on their side until they’re fully awake. Check for injuries, especially to the head, tongue (they may have bitten it), or limbs. Tell them what happened in a calm, matter-of-fact way. Don’t crowd them or bombard them with questions. Many people need 15 to 30 minutes to feel like themselves again, and some feel wiped out for the rest of the day.
If You Feel a Seizure Coming On
Some people experience a warning, sometimes called an aura, before a seizure starts. This might feel like a strange taste or smell, a wave of nausea, a sense of déjà vu, visual disturbances, or a rising feeling in the stomach. If you recognize these signals, you may have seconds to a couple of minutes to act.
Get to the ground or sit down immediately, ideally away from hard furniture, stairs, or roadways. If you’re standing near a street, move away from traffic. Let someone nearby know what’s about to happen. If you’re alone, try to get to a carpeted or soft surface and lie on your side. Avoid locking yourself in a bathroom, since a fall against the door can trap you inside.
Making Your Home Safer
If you have recurring seizures, small changes to your living space can prevent serious injuries. The bathroom is the most dangerous room because it combines hard surfaces, water, and small spaces.
Install your bathroom door so it swings outward into the hallway. If you fall during a seizure, your body won’t block the door and prevent someone from reaching you. Put non-skid strips in your tub or shower, and add grab bars to the walls. If you fall frequently during seizures, use a shower chair or sit on the bottom of the tub with a handheld shower nozzle instead of standing.
Beyond the bathroom, pad sharp furniture corners in rooms where you spend the most time. Keep floors clear of clutter that could cause injuries during a fall. If you cook, use back burners when possible and turn pot handles inward. Some people find it helpful to keep a phone within reach at all times, either in a pocket or clipped to clothing, so they can call for help during the recovery phase if they’re alone.
Building a Seizure Plan
If seizures are part of your life, having a plan in place takes pressure off the people around you. Write down what your seizures typically look like, how long they last, and what kind of help you need afterward. Include whether someone should call 911 or just stay with you, and note any medications you take.
Share this plan with the people you see regularly: family, coworkers, close friends, roommates. A medical ID bracelet or a card in your wallet with this information can help strangers respond correctly if a seizure happens in public. The more specific your instructions, the less likely someone is to panic or do something unhelpful.