First Aid For Seizures: A Step-by-Step Emergency Guide
Learn step-by-step first aid for seizures, including what to do, what not to do, when to call for emergency help, and how to care for someone after a seizure.
Written by Dr. Dhankecha Mayank Dineshbhai
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 12th Sep, 2025
Introduction
Witnessing someone have a seizure can be a frightening and overwhelming experience. In that moment, knowing what to do and what not to do is critical. Seizures are a sudden, uncontrolled electrical disturbance in the brain that can cause changes in behaviour, movements, feelings, and levels of consciousness. This guide provides clear, actionable steps for administering proper aid during seizures, empowering you to act confidently and effectively in an emergency. We will cover everything from immediate response and safety measures to post-seizure care and when to call for help, ensuring you are prepared to provide the best possible support.
What is a Seizure? Understanding the Basics
A seizure is not a disease in itself but a symptom of a sudden, temporary disruption in the brain's normal electrical activity. Think of it as an electrical storm in the brain that can cause a wide range of physical and mental symptoms. While epilepsy is a common cause of recurrent seizures, they can also be triggered by high fevers (especially in children), severe head injuries, stroke, infections, low blood sugar, and certain medications.
There are many types of seizures, but they are broadly categorised into two groups: focal (starting in one part of the brain) and generalised (involving both sides of the brain from the start). The most recognisable, and the type that requires the most hands-on first aid, is the generalised tonic-clonic seizure (formerly known as a grand mal seizure), characterised by loss of consciousness, stiffening of the body, and jerking movements.
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Step-by-Step: What to Do During a Tonic-Clonic Seizure
If you see someone experiencing a convulsive seizure, follow these five crucial steps.
Step 1: Stay Calm and Start Timing
Your first and most important job is to stay calm. Take a deep breath. Your composure will allow you to help effectively. Immediately note the time the seizure began. Seizure duration is a key factor in determining if it's a medical emergency.
Step 2: Ensure Safety and Clear the Area
Gently lower the person to the floor if they are not already there. Quickly look around and remove any hard or sharp objects they could hit during their convulsions. This includes furniture, glass tables, and sharp corners. If they are wearing glasses, carefully remove them.
Step 3: Cushion the Head and Loosen Restrictive Clothing
Place something soft and flat under their head, like a folded jacket, sweater, or a pillow if one is nearby. This protects their head from repeated impact on the floor. If possible, loosen any tight clothing around their neck, such as a tie or shirt collar, to aid breathing.
Step 4: Gently Roll Them onto Their Side (After Convulsions Stop)
Once the violent jerking movements have subsided, carefully roll the person onto their side into the recovery position. This allows saliva or vomit to drain from the mouth, preventing choking. Their top leg can be bent to stop them from rolling onto their stomach.
Step 5: Stay With Them Until They Are Fully Alert
The person will be confused, fatigued, and disoriented as they wake up. This post-seizure period is called the postictal state. Speak to them in a calm, reassuring tone. Let them know what happened and that they are safe. Do not offer them food or water until they are fully alert, as they could choke.
Critical Mistakes: What NOT to Do During a Seizure
Knowing what not to do is just as important as knowing what to do. Avoid these common and dangerous myths:
- Do not restrain the person. Holding them down will not stop the seizure and may cause injury to you or them.
- Do not put anything in their mouth. The old myth of swallowing the tongue is physiologically impossible.
- Forcing an object into their mouth can chip teeth, injure the jaw, or cause them to choke.
- Do not try to give mouth-to-mouth resuscitation during the convulsive phase. The person's breathing may be irregular or sound laboured, but it will typically resume on its own.
- Do not offer food or water until the person is completely awake and aware.
When is a Seizure a Medical Emergency?
While not every seizure requires an ambulance, you must call emergency services immediately if:
- The seizure lasts longer than 5 minutes.
- A second seizure begins immediately after the first one ends.
- The person is injured during the seizure (e.g., from a fall).
- The seizure happens in water, like a pool or bathtub.
- The person has difficulty breathing or waking up after the seizure has stopped.
- The person is pregnant, has diabetes, or has a known heart condition.
- It is the person’s first known seizure.
If you are unsure, it is always better to err on the side of caution and call for help. If the person is known to have epilepsy but the seizure fits the emergency criteria above, you should still call emergency services. For any new or unexplained seizure, a follow-up with a neurologist is essential. You can consult a specialist online with Apollo24|7 for an initial evaluation and guidance.
The Recovery Phase: Caring for Someone After a Seizure
The end of the convulsions is not the end of the episode. The postictal state can last from minutes to hours. The person may be confused, sleepy, agitated, or have a headache. Continue to provide reassurance and a safe, quiet space. Do not overwhelm them with questions. Explain what happened in simple terms. Once they are fully alert and able to swallow safely, you can offer them water. Stay with them until you are confident they can care for themselves or are with a responsible adult.
First Aid for Focal Aware and Impaired Awareness Seizures
Not all seizures involve convulsions. In a focal impaired awareness seizure (formerly complex partial seizure), a person may appear confused, dazed, or space out. They may make repetitive movements like chewing, lip-smacking, or fumbling with clothes. They are not aware of their surroundings and cannot respond.
- Do: Speak calmly and gently guide them away from any danger such as stairs or traffic.
- Do not: Restrain them or shout at them, as this may cause agitation.
- Do: Stay with them until the episode passes and they are fully aware.
Conclusion
Witnessing a seizure can be alarming, but being prepared transforms fear into empowered action. By memorising these simple first aid steps, focusing on safety, timing, and avoiding harmful myths, you can provide vital support during a vulnerable moment. This knowledge enables you to protect someone from injury and reassure them until they recover. If you or someone you know experiences a seizure for the first time, or if seizure patterns change, it is crucial to seek professional medical advice to determine the underlying cause and the right management plan.
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Consult Top Neurologists
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Lakshaman K
Neurologist
19 Years • MBBS,MS General Medicine,MCH Neurosurgery
Bengaluru
R V speciality Clinic, Bengaluru
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS, MD(GENL.MED.),DM(NEUROLOGY)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
(25+ Patients)
Dr. Joydeep Biswas
Neurologist
15 Years • MBBS, DNB General Medicine, DNB Neurology
Barasat
Diab-Eat-Ease, Barasat
Consult Top Doctors for Personalised Advice
Dr. Aditendraditya Singh Bhati
Neurosurgeon
18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy
Delhi
Apollo Hospitals Indraprastha, Delhi
(100+ Patients)
Dr. Lakshaman K
Neurologist
19 Years • MBBS,MS General Medicine,MCH Neurosurgery
Bengaluru
R V speciality Clinic, Bengaluru
Dr. Ganeshgouda Majigoudra
Neurologist
10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Uddalak Chakraborty
Neurologist
8 Years • MBBS, MD(GENL.MED.),DM(NEUROLOGY)
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
(25+ Patients)
Dr. Joydeep Biswas
Neurologist
15 Years • MBBS, DNB General Medicine, DNB Neurology
Barasat
Diab-Eat-Ease, Barasat
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Frequently Asked Questions
Can a person swallow their tongue during a seizure?
No, this is a medical myth. It is physically impossible to swallow your tongue. However, the tongue can relax and fall back to block the airway. Placing the person in the recovery position after the seizure helps prevent this.
Should I try to hold the person down to stop the jerking?
Absolutely not. Restraining a person during a seizure will not stop the convulsions and can lead to serious injuries like broken bones or muscle strains for both of you. Focus on protecting them from their environment instead.
Is it normal for a person to stop breathing during a seizure?
It may appear that way. Breathing can often become irregular, shallow, or even pause briefly during the tonic (stiffening) phase of a convulsive seizure. It typically resumes on its own. Focus on ensuring their airway is clear after the jerking stops.
What should I do if a seizure happens in water?
This is a life-threatening emergency. Support the person's head to keep it above water and call 911 immediately. Once out of the water, check for breathing and begin CPR if needed, and continue to follow standard seizure first aid protocols.
How long does it take to recover after a seizure?
The recovery period (postictal state) varies. It can last from a few minutes to several hours. Common feelings include confusion, exhaustion, headache, and a need to sleep. Offer a calm, safe space for them to rest until they feel like themselves again.