First Aid During a Seizure

This is probably the chapter you'll turn to most in the whole book. Witnessing a seizure is frightening; but knowing the right steps in advance gives you strength and calm in the moment. The steps are far simpler than you might think. Read these pages — take a photo of them and keep it on your phone, and share it with the other people in your home.

The Golden Rule: Stay Calm and Time It

The great majority of seizures stop on their own within a few minutes, even if you do nothing. Your job isn't to “stop” the seizure, but to keep the child safe until it passes. As soon as the seizure begins, look at the clock; knowing how long it lasts is the only way to tell when emergency help is needed.

WHAT TO DO

• Stay calm. Take a deep breath. Panic affects both you and those around you.
• Start the timer. Look at your watch or phone and note the time the seizure began.
• Make the child safe. Move away hard, sharp, or dangerous objects nearby (furniture, hot drinks, glass). If there's a risk of falling, ease them down to a safe spot on the floor.
• Protect the head. Place something soft under the head (a folded jacket, a pillow, a bag). Remove anything tight around the neck, such as a tie or scarf, and take off glasses.
• Turn on the side. If possible, gently turn the child onto their side (the recovery position). This lets saliva and fluid drain from the mouth and keeps the airway open.
• Stay with them. Don't leave the child's side throughout the seizure. Speaking in a calm, soft voice is soothing both during and after the seizure.
• Observe. Keep in mind what's happening (which limb, the direction of the eyes, how long it lasts), or if possible have someone record a video. This is very valuable for your doctor.
• Be there afterward. When the seizure ends, the child may be tired, confused, or sleepy. Stay with them until they come round, reassure them, and gently explain what happened.

WHAT NOT TO DO — These mistakes cause harm

Don't put anything in the mouth. Not a finger, not a spoon, not a cloth. The belief that they'll “swallow their tongue” is wrong. Putting something in the mouth can break teeth, injure the jaw, get you bitten, and block the airway.

Don't try to hold the child down or force their movements to stop. Trying to prevent the convulsions can cause muscle and joint injuries. The seizure will run its own course.

Don't give water, medicine, or food. During and right after a seizure the child can't swallow; giving anything by mouth can cause choking (aspiration).

Don't try to stand the child up or walk them.

Don't do CPR (chest compressions / rescue breaths) during the seizure. While the seizure is going on there's no need for it, and it can be harmful; when the seizure ends, the child usually starts breathing on their own. However, if the child isn't breathing normally after the seizure has ended, call 112 right away and, following the operator's guidance, give basic life support (CPR).

Helping a Child Having a Seizure — Quick Poster

First Aid in Absence and Focal Seizures

Not all seizures are tonic-clonic. If a child is simply staring blankly (absence) or making aimless movements with clouded awareness (a focal seizure with impaired awareness), act differently: don't try to hold them, but gently keep them away from dangers (stairs, the street, the stove). Stay with them, guide them in a calm voice, and stay by their side until they fully come round. In these kinds of seizures the child doesn't fully take in their surroundings, so sudden movements can startle them; keep your approach gentle.

After the Seizure (the Postictal Period)

After a seizure, a child may sleep for a while, be confused, have a headache or muscle aches, and may even seem restless or aggressive. This is normal and part of the brain's recovery process. Don't push them, be calm and patient, and provide a safe and quiet environment. As they come round, explain what happened in simple, non-judgmental terms; children often don't remember the seizure, and that can frighten them.

When to call 112? (A reminder)

Call 112 if the seizure lasts longer than 5 minutes; if seizures come one after another; if there's a breathing problem or a long loss of consciousness after the seizure; if the seizure happened in water or there's a serious injury; if it's a first seizure; or if the seizure doesn't stop despite the rescue medicine. (For details, see Chapter 27.)

After the Seizure: What to Say to the Child?

When the child comes round after the seizure has passed, what they need most is a sense of security. It's important not to frighten them further with your own panic. In a calm tone, use short, soothing sentences like, “You had a little seizure, it's over now, you're safe, I'm right here with you.” Explain what happened without exaggerating, but without hiding it either. If the child doesn't remember the seizure, help them make up for the time they lost, and avoid judging or saying things like “not again.”

Notes for Someone Witnessing a Seizure for the First Time

A grandparent, teacher, neighbor, or sibling can be very frightened when they witness a seizure for the first time. Preparing them in advance is valuable both for the child's safety and so that person doesn't panic. Teach these people three things: stay calm and time the seizure; make the child safe and turn them on their side; don't put anything in the mouth and don't try to hold them down. These three steps are enough for most seizures. They should also know when to call 112.

Teach seizure first aid to everyone

It's lifesaving for everyone who regularly cares for your child (partner, grandparents, caregiver, teacher, coach) to know these simple steps.

Make copies of the fridge quick-reference card in Appendix H and share it with these people. A short practice run builds confidence for the real moment.