You do not need to be a qualified first aider to help and support someone during and after a seizure. Most seizures will stop on their own, and will not require any intervention.  

Family, friends or work colleagues may appreciate knowing basic seizure first aid so they can help and support you or someone they care for during and after a seizure and keep them safe. 

Have a look at the following simple step by step guide to help someone who has a tonic-clonic seizure.  For more information on how to help someone with a different type of seizure, check out our First aid for seizures publication.

How to help someone having a tonic-clonic seizure

A tonic-clonic seizure is the type of seizure where someone suddenly loses consciousness, falls over, and starts convulsing (jerking). It used to be known as a ‘grand mal’ seizure.

  • time the (convulsive part of the) seizure
  • wipe away any vomit or saliva to keep their airway clear
  • move any objects that could cause injury
  • put something soft like a jacket or cushion under the person’s head
  • loosen tight clothing around the neck
  • remove any glasses
  • if possible, turn the person into the recovery position during convulsions but do not restrain or hold down the person.
  • reassure others and stop other people from crowding around

 

Once the convulsive (jerking) phase has stopped:

  • maintain their airway by tilting their head slightly backwards, if possible
  • check if they have injured themselves
  • turn the person onto their side (recovery position) if you haven’t managed to do this during convulsions
  • check nothing has blocked their airway, such as dislodged dentures or inhaled food
  • stay with the person until their breathing and colour has returned to normal
  • Explain what happened and talk gently to help re-orientate the person and stay with them until fully recovered.

Some people carry medical identification such as a bracelet or necklace, or a small card.  Check for this as it can give more information on the person’s epilepsy.

If you want to carry a card with details about your epilepsy, request a free ‘I have epilepsy’ card from us by phoning our helpline.

If you know the person has a care plan, this will give you more information about their seizures and if/when to give emergency medication.

Emergency medication is usually prescribed by the person’s doctor to help with prolonged seizures. The care plan will also specify what to look out for, who can give emergency medication and when to call an ambulance.

 

What not to do:

  • DO NOT move the person unless they are in danger, ie on a busy road or at the top of stairs
  • DO NOT try to stop the convulsing or restrain the person
  • DO NOT put anything in the person’s mouth or between their teeth
  • DO NOT offer the person anything to eat or drink until they are fully conscious and their breathing has returned to normal

 

Only call an ambulance, unless:

  • this is the person’s first seizure as far as you are aware
  • the person is badly injured
  • the person may have inhaled food, drink or vomit
  • the convulsions last for five minutes, or longer than is normal for that person
  • one seizure follows another with no recovery in between
  • the person is having problems breathing after the seizure has stopped
  • do not hesitate to call an ambulance if you have any concerns.

Emergency Medication

Most seizures are short, will stop on their own and do not require any medical intervention.  Seizures can become a medical emergency if the seizure lasts two minutes longer than usual, or five minutes in total as a general guidance.

A medical emergency can also arise if a person has one seizure after another without full recovery in between.  Full recovery means return to full consciousness and normal breathing.

A prolonged seizure can lead to status epilepticus.  This is defined as a seizure which does not stop on its own.  Status epilepticus is always a medical emergency and requires medical intervention.  It is more likely to happen with uncontrolled seizures.

Emergency medication is usually prescribed after a person has had their first prolonged seizure.  It can stop a prolonged seizure or serial seizures, and should be administered long before a medical emergency arises to prevent the person going into status epilepticus.

Any person who has been prescribed emergency medication will have a detailed care plan which will specify for carers what to look out for, when to give emergency medication and when to call an ambulance.

You can find out more about this in our Emergency medication publication.

For more detailed information about first aid read our publications below. Our training courses also cover first aid for seizures.

Publications

With all other types of seizure, simply stay with the person, talk gently and reassure, and keep them safe until they have fully recovered.

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