First Aid for Seizures

Convulsive Seizures (tonic, clonic, tonic-clonic)

     Rule 1:   Be a good observer, keep calm.

Speak softly and calmly to the person.  Don't panic. People almost never die from a seizure, but subsequent medical care may depend critically on your observations of the seizure.  For example:  Did the patient stop talking in mid-sentence?  Did one limb start jerking before the others?  Were the movements symmetric and synchronous?

     Rule 2:   Do not attempt to force anything in the patient's mouth!

It is unnecessary, may cause the patient harm (break his teeth) or harm to yourself (he can bit your finger off).  The patient cannot swallow his tongue, and any tongue biting or cheek biting usually  occurs within the first seconds.  Most seizures last only a few minutes, and there is nothing you can do to stop them. Do not start CPR.  The patient rarely stops breathing and, if he does, it is usually brief.

     Rule 3:   Protect the patient from harm.

The patient will fall down and his movements might cause him to hit his head or extremities on hard objects, so clear the area and put something soft under his head.  Don't hold the patient down!  Any attempt to stop movements may actually cause injury. If possible, the patient should not be moved.

     Rule 4:   Place the patient on his side after the convulsion to keep the airway clear.

Although uncommon, patients may vomit, and this will prevent aspiration.  Do not offer anything to eat or drink until fully awake (including seizure medications).

     Rule 5:   Do not call for an ambulance immediately.

Patients with epilepsy will have seizures in public.  This does not require emergency room service and the high medical costs involved. Wait for the patient to wake up and ask if he or she wants
an ambulance. If the seizure lasts longer than 30 minutes, or the patient has repetitive seizures, this may indicate status epilepticus and an ambulance should be summoned immediately.

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Complex Partial Seizures

     Rule 1:   Observation of behavior is vitally important.

     Rule 2:   Nothing in mouth.

     Rule 3:   Protect from harm.

In these seizures the patient may wander about and occasionally drop or knock over objects.  Be very gentle with him, calmly direct him, and try to talk him into sitting down away from any danger.

However, be aware that if you are too physical or try to restrain him, he can get aggressive or violent.

     Rule 4:   Allow him to sleep after the seizure.

     Rule 5:   Do not call for an ambulance.