Watching someone have a seizure can be terrifying, especially if it catches you off guard. The good news is that most seizures end on their own within a few minutes. That said, in certain situations, you should call 911 right away, and recognizing those red flags matters just as much as the first aid steps themselves.
This guide walks you through how to help someone having a seizure, what mistakes to avoid, when to call for emergency help and what to expect if someone needs care at an emergency hospital. If you’re ever in this situation, it may help to know that Baylor Scott & White Emergency Hospitals provide emergency medical care at eight convenient locations in the Dallas-Fort Worth Metroplex.
Recognizing Different Types of Seizures
A seizure happens when the brain experiences a sudden surge of abnormal electrical activity. What it looks and feels like can vary quite a bit depending on which part of the brain is affected. There are two main categories.
Generalized seizures affect both sides of the brain at once and often cause a loss of consciousness. The most recognized type, tonic-clonic seizures, involve stiffening and rhythmic jerking. With absence seizures, the person simply might stare into space for a few seconds, which can easily be missed.
Focal seizures begin in one part of the brain. Depending on the type, the person may remain aware or become confused and unresponsive. You might notice repetitive movements such as lip smacking, picking at clothing or unusual behavior. If you see any of these signs, stay calm and pay attention to how long it lasts.
The Stay Safe Side Approach to Seizure First Aid
The Epilepsy Foundation’s Stay, Safe, Side framework is one of the most practical ways to remember what to do in the moment.
Stay means staying with the person throughout the seizure. Don’t leave to seek help if you can avoid it. Check for a medical ID bracelet if it’s safe to do so, and time the seizure from start to finish.
Safe means doing what you can to protect the person from harm. Move sharp objects, furniture or other hazards out of the way. If the person is falling, try to ease them gently to the ground. Place something soft and flat beneath their head, loosen any tight clothing around their neck and ask bystanders to give them space.
Side means turning the person onto their side if they’re lying down and unconscious. This will keep their airway open. Once convulsions stop, keep them on their side until they’re awake and aware, and stay with them until they’re fully alert and safe.
Most seizures Stop on their own within one to three minutes. You don’t need to intervene beyond keeping the person safe.
Critical Mistakes To Avoid During a Seizure
When someone is having a seizure, the instinct to intervene can actually cause more harm than good. Here’s what you should avoid:
- Don’t hold the person down. Restraining someone during a seizure can cause physical injury to both of you and may leave them more agitated and confused when they come around.
- Don’t put anything in their mouth. This includes fingers, wooden spoons or any other object. It’s a common myth that people can swallow their tongue during a seizure. In reality, objects in the mouth can crack teeth, injure the jaw or create a choking hazard.
- Don’t attempt mouth-to-mouth resuscitation while the seizure is still happening.
- Don’t offer food, water or medication until the person is fully awake and alert. Even a small amount can cause choking if they haven’t fully recovered.
- Don’t crowd around the person. Keep the space calm and give them room to breathe.
- Don’t leave the person alone until they’re safe, aware of their surroundings and fully recovered.
Seizure Red Flags That Call for Emergency Help
You don’t need to know what type of seizure someone is having to recognize when it’s time to call 911. The following signs indicate a seizure emergency, so don’t wait:
- The seizure lasts longer than five minutes.
- A second seizure begins shortly after the first one ends.
- The person doesn’t wake up or return to their usual state after the seizure.
- The person is visibly injured and has trouble breathing.
- This is their first known seizure.
- The person has diabetes and loses consciousness.
- The person is pregnant.
- The person is sick, has a fever or shows signs of infection.
- The person has recently had a head injury.
Post Seizure Care
There are a few things to be mindful of when dealing with a person who has just had a seizure. The person will probably feel tired, confused or embarrassed, which is normal. Try to keep the area around them quiet and avoid overcrowding. Also, keep them on their side until they’re fully awake. Once they’re alert, tell them gently what happened and offer to contact a friend, family member or caregiver on their behalf.
What To Expect in the ER After a Seizure
When someone arrives at an emergency hospital following a seizure, the care team will check their vital signs and blood sugar levels and conduct a neurological exam. They’ll ask about the episode, how long it lasted, if there were any movements, if the person has a history of seizures, what medications they’re taking and if they have any relevant medical conditions.
Testing may include blood work to check electrolyte levels. If this is the first seizure the patient has had, doctors may use imaging tests such as CT scans to look for problems in the brain that could have caused the seizure. Baylor Scott & White Emergency Hospitals offer on-site diagnostic services, including CT scans, X-rays, ultrasound and laboratory testing, as part of emergency care. For patients who need to stay overnight, inpatient care and support services are also available.
Build Confidence Through Proper Seizure Training
Knowing how to respond and when to go to the ER for a seizure can genuinely protect someone’s life. The steps aren’t complicated, but they do require you to stay calm and think clearly in a stressful moment. Reviewing seizure first aid regularly and sharing this information with family members, teachers and coworkers can help build that confidence before you ever need it.
If someone has a seizure lasting longer than five minutes, has repeated seizures, has trouble breathing or waking up, is injured, is pregnant, has diabetes and loses consciousness or has a first-time seizure, call 911 right away. For information about emergency services and care options across the Dallas-Fort Worth Metroplex, get in touch with a Baylor Scott & White Emergency Hospital location near you.