Having a seizure is a frightening experience. So is witnessing someone having a seizure.
Seizures may be caused by epilepsy, a common disorder of the brain. They also may be caused by an injury, infection, medication, stroke or even lack of sleep. No matter what the cause, seizures are common—1 in 10 people may have at least one during their lifetime.
We talked with UNC Health neurologist Clio Rubinos, MD, about what you should do if someone near you is having a seizure.
“Most seizures will end in a few seconds or minutes,” she says. “It’s important that the person with them stay calm and reassure them. Keep them safe, but don’t try to hold them down or stop the seizure.”
She has this advice for people who may be present when someone has a seizure.
Do: Recognize the symptoms of a seizure.
Symptoms of seizure can be varied, Dr. Rubinos says. They can range from blinking or staring into space as if the person is daydreaming, to losing motor control, shaking and falling to the ground.
The person having a seizure may seem confused or in a haze. They may have spasms in an arm, leg or multiple limbs. They may smack their lips. They may grab their clothes or wipe their nose with their right or left hand. They may lose control of their bladder or bowels. They may seem awake, but do something erratic, like take a shower with their clothes on or try to cut a sandwich with the remote control.
Do: Remain calm and know when to call 911.
Seizures generally last only a few seconds or minutes and stop on their own, Dr. Rubinos says. If you don’t know the person, check to see if they are wearing a medical bracelet or other emergency information.
Most seizures are not emergencies, but call 911 if the seizure lasts five minutes or longer, it’s the person’s first seizure or the person turns blue from lack of oxygen. You may also call 911 if the person experiences two seizures back-to-back, if they get hurt during the seizure or if they have trouble breathing or walking after the seizure. If the person having a seizure has a health condition, such as diabetes, or is pregnant, calling 911 is a good idea.
And, of course, it’s never wrong to err on the side of calling 911, especially if you don’t know the person or their medical history.
Do: Stay with the person during the seizure.
During the seizure, stay with the person and provide reassurance.
“They may or may not hear you,” Dr. Rubinos says, “but do it anyway. It helps keep the situation calm.”
After the seizure is over, you may need to tell the person what happened. Make sure they get home or wherever they are going safely. Offer to call a friend or family member for them.
Do: Keep the person safe within the bounds of your own safety.
If you’re near someone having a seizure, you may be able to take steps to keep that person safe—as long as you can do so while remaining safe yourself.
“Move any item that can be harmful,” Dr. Rubinos says, “such as sharp objects or a table that could fall on them.”
Loosen clothing or jewelry around their neck to help prevent choking. Remove eyeglasses if they are wearing them.
Get the person to a safe location if you can. For example, if they have a seizure while crossing the street, get them to the side. If they are in the kitchen, move them to a living room or bedroom that may have fewer dangerous items, such as knives.
If they are lying on the floor and in danger of hitting their head, put a pillow or something else soft, like a jacket or sweatshirt, under their head.
Despite common belief, a person having a seizure cannot swallow their tongue.
Do: If they are unconscious, move them onto their side.
It may be easier for a person having a seizure to breathe if they are on their side.
“They may vomit,” Dr. Rubinos says. “If they are on their side, there’s less chance they will aspirate or suffocate.”
If they are unconscious but not on the ground—maybe in a chair or on a couch—try to move them sideways so their airways are more likely to stay open.
Do: Check to see if the person is breathing.
Often during a seizure, a person’s chest muscles tighten so they are unable to breathe. But as the seizure ends, the muscles will relax and the person will begin breathing normally again.
If the person is not breathing, especially if they are turning blue, give rescue breath (mouth-to-mouth resuscitation) if you feel you can do so safely. Have someone else call 911 while you work.
Don’t: Try to hold the person down or stop their movements.
Do not try to hold the person down or try to stop their movements, Dr. Rubinos says. Stopping a person’s movements won’t stop the seizure, but it can cause injuries to the person having the seizure and to the person trying to hold them down. Suppressing their movements may cause the person to be more confused, agitated or even aggressive.
Don’t: Give food or water or put anything in the person’s mouth.
During a seizure, a person may not be able to swallow correctly, so do not offer food, water or anything else they have to swallow until they are fully alert.
Do not put anything in the person’s mouth. People used to do this to keep the person from biting their tongue or cheek, but there is greater danger in putting an object in the person’s mouth during a seizure.
“You can create suffocation if their jaw clinches,” Dr. Rubinos says. “Or they can break anything you put in their mouth and it can go into the back of their throat and choke or suffocate them.”