If someone near you is having a seizure, the most important thing you can do is stay calm, clear the area around them, and let the seizure run its course. 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.
What to Do During the Seizure
Start timing the seizure as soon as you notice it. This is critical because a seizure lasting longer than 5 minutes is a medical emergency. Use your phone’s clock or stopwatch so you have an accurate count rather than a guess.
While the seizure is happening, move anything nearby that could hurt the person: chairs, sharp objects, hard furniture. If they’re on the ground, gently guide their head away from anything solid like a table leg or curb. You don’t need to move the person themselves unless they’re in immediate danger, like in a street or near a ledge. If they’re lying down, gently roll them onto their side with their mouth pointing toward the ground. This keeps their airway clear and prevents them from choking if they vomit.
Look for a medical alert bracelet or necklace. It may list their condition, medications, or an emergency contact, all of which will be useful information if paramedics arrive or when the person wakes up.
What Not to Do
There are a few deeply ingrained instincts that will actually make things worse:
- Don’t put anything in their mouth. The old idea of placing a wallet or spoon between someone’s teeth to “prevent them from swallowing their tongue” is a myth. It’s physically impossible to swallow your own tongue. Forcing something into the mouth during a seizure can crack teeth, injure the jaw, or cause the person to choke.
- Don’t hold them down or try to stop the shaking. Restraining someone mid-seizure can cause muscle tears, joint injuries, or bone fractures for either of you. The movements will stop on their own.
- Don’t give mouth-to-mouth breathing. Breathing may look irregular or even pause briefly during a seizure, but it almost always resumes on its own once the seizure ends.
- Don’t offer food or water until the person is fully awake and alert. Swallowing is impaired after a seizure, and anything in the mouth is a choking risk.
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 after the shaking stops.
- A second seizure follows shortly after the first.
- The person is injured during the seizure.
- It’s their first known seizure.
- The person is pregnant, has diabetes, or had the seizure in water.
- They stop breathing and don’t start again once the seizure ends.
A seizure lasting more than 5 minutes is called status epilepticus, and it can cause brain damage without medical intervention. That 5-minute mark is the single most important number to remember.
After the Seizure Ends
When the shaking stops, the person enters a recovery phase that can last anywhere from a few minutes to over an hour. During this time they may be confused, drowsy, embarrassed, or even agitated. Some people don’t remember what happened. Others may have a headache or feel nauseous.
Help them sit somewhere safe and comfortable. Speak calmly and tell them what happened, where they are, and how long the seizure lasted. Don’t rush them. Confusion after a seizure is normal and will clear gradually. If they’re still lying down and not fully conscious, keep them on their side in the recovery position and monitor their breathing until they come around. If breathing stops or you can’t find a pulse, begin CPR immediately.
Once they’re alert, offer to call a friend or family member to help them get home. Most people shouldn’t drive after a seizure, and many feel drained for hours afterward.
Seizures That Don’t Involve Shaking
Not all seizures look like the dramatic convulsions you see in movies. Some seizures cause a person to stare blankly, smack their lips, pick at their clothing, or wander around looking confused. They may not respond when you talk to them. These episodes are still seizures, and the same core principles apply: stay with them, gently guide them away from hazards like traffic or stairs, don’t restrain them, and time the episode. Once it passes, stay with them until they’re fully aware of their surroundings again.
If the Seizure Happens in Water
A seizure in a pool, bathtub, or open water is always a medical emergency. Support the person’s head above the surface and get them out of the water as quickly as possible. Once they’re on solid ground, check whether they’re breathing. If not, start 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.