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Seizure First Aid

There are things you can do during a seizure to help someone with epilepsy make a safe recovery. No matter what type of seizure the person has, the three most important things you can do are:
  1. Remain with the person.
  2. Do not restrain the person, unless imminent danger exists and there is no other alternative.
  3. Remain calm.
First aid for seizures is not complicated. The main principle of seizure first aid is to protect the person from harm when they are not able to do so for themselves.

Providing first aid may also include a calming explanation to those at the scene and encouragement to carry on with their own activities. Recognizing what is happening and responding appropriately and effectively to a seizure will minimize its effect, prevent inaccurate assumptions, and protect the dignity of the individual.

Complex Partial Seizure

What to Do What Not To Do
  • Speak calmly and reassuringly.
  • Gently guide the person away from obvious hazards.
  • Stay with the person until she or he is fully re-oriented or in the care of another responsible individual.
  • Use standard questions regarding name, date, place, etc. to re-orient the person to his or her environment. This will let you know if he/she has regained awareness.
  • If confusion is prolonged, call for an ambulance.
  • Do not restrain or interfere with the person’s movements.
  • Do not raise your voice or appear threatening.
  • Do not expect the person to respond to you during the seizure.
  • Do not interpret struggles or other behavior as consciously directed or aggressive.
  • Do not leave the person unassisted unless you are sure he or she is fully re-oriented or is in the care of another responsible individual.
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Simple Partial Seizure

What to Do What Not To Do
  • Observe behavior and provide reassurance if individual is frightened or confused.
 
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Generalized Tonic-Clonic (Convulsive) Seizure

What to Do What Not To Do
  • Protect the individual from nearby hazards and move to a horizontal position if possible.
  • Protect the person’s head from injury. Place something soft, such as a sweater, under the head.
  • Time the seizure.
  • When the seizure has ended, turn the person onto their side (see recovery position below) to keep their airway clear.
  • Reassure the person - speak in a calm and friendly manner.
  • Check time elapsed. If the seizure lasts longer than 5 minutes, or if a second seizure begins without a recovery period in between, call for an ambulance.
  • Stay with the person until he/she is fully re-oriented. Use standard questions regarding name, place, etc. to help determine whether the person has regained awareness.
  • If possible, keep a blanket nearby in case bowel or bladder control is lost; this will help maintain privacy and dignity.
  • Do not restrain the person’s movements.
  • Do not put anything in the mouth. It is impossible for the tongue to be swallowed. Turning the person onto his or her side will keep the airway clear.
  • Don’t raise your voice or appear threatening.
  • Do not use artificial respiration or CPR unless breathing doesn’t resume after the convulsions have stopped.
  • Do not leave the person alone unless you are sure he or she is fully re-oriented or is in the care of another responsible individual.
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Absence Seizure

What to Do What Not To Do
  • Provide any missed information.
  • Provide a partner to assist the child in keeping up with in-class activities.
  • Provide reassurance if needed.
  • Do not berate or disparage the child.
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Atonic and Tonic

What to Do What Not To Do
  • Reassure the person and check for injuries.
 
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Myoclonic

What to Do What Not To Do
  • Provide reassurance.
 
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The Recovery Position

The recovery position allows fluids to drain from the nose and throat so they are not inhaled. This position should not be used if an injury to the back or neck is suspected.

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When to Call an Ambulance

An uncomplicated seizure, convulsive or otherwise, in someone who has epilepsy is usually not a medical emergency. Most seizures are self-limiting and stop naturally after a few minutes without ill effects. In most cases, the person experiencing the seizure will be able to resume normal functioning after a brief rest period.

However, there are some times when an ambulance should be called:
  • If the person has no medical identification and you are not sure the person has epilepsy
  • If the seizure lasts longer than 5 minutes
  • If one seizure follows another without a full recovery or return to consciousness in between
  • If the person is pregnant or injured, or another medical condition is implicated
  • If consciousness does not return when the seizure is over
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