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First aid for tonic-clonic and absence seizures

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Our Helpline & Information Officer, Stuart Macgee will be looking at first aid for seizures as part of a new blog series. Part one looks at first aid for tonic-clonic and absence seizures.

Most seizures are self-limiting and will stop on their own. However, knowing simple first aid steps can help keep a person safe during and after a seizure.

If you are living or looking after someone with epilepsy talk to them or their epilepsy specialist nurse / GP in advance and find out what to do:

  • if the person is unconscious
  • if the person has injured themselves and / or is bleeding
  • if the person has something stuck in their throat
  • if the person has difficulty breathing or if they stop breathing
  • when to call an ambulance

Below is an overview of first aid steps for different seizure types. In part one of this blog series looks at first aid for tonic-clonic and absence seizures.

 

First aid for tonic-clonic seizures

What is a tonic-clonic seizure?

People usually have a tonic-clonic seizure in mind when they think of epilepsy. Tonic-clonic seizures used to be called grand mal epilepsy.

A person will stiffen during a tonic-clonic seizure. This is called the tonic stage. If the person is standing, they will fall and their breathing temporarily stops.

The next stage is the clonic stage where the person starts to jerk. They may make a grunting noise, produce a lot of saliva, bite their tongue, and / or empty their bladder and / or bowels. The jerking usually stops after a couple of minutes.

Because breathing is affected during a tonic-clonic seizure the skin can become pale and the lips may go blue.

Once the seizure has stopped, the breathing returns and the colour will return to normal. The person will come round slowly. They may feel sleepy and confused afterwards. Some people have a headache or sore arms and legs and it can take time to feel well again.

 

What to do if someone has a tonic-clonic seizure

  • keep calm
  • check the time to see how long the seizure lasts
  • move any objects that could cause injury
  • put something soft like a rolled-up jacket or cushion under the person’s head to prevent injury
  • maintain the person’s airway by wiping away any vomit or saliva, and / or tilting the head slightly backwards (this can usually only be done after convulsions have stopped)
  • loosen tight clothing around the neck
  • remove glasses
  • stop other people crowding around
  • check for medical identification as this may have more information on the person’s epilepsy
  • turn the person onto their side into the recovery position as soon as the jerking stops
  • protect the person’s privacy, particularly if they have emptied their bladder and / or bowels
  • speak softly and gently when you tell the person what has happened
  • remember they may be confused after a seizure
  • do not move the person unless they are in danger, eg on a busy road or at the top of the stairs
  • do not try to stop the jerking 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.

Once a seizure starts it will usually stop on its own.

First aid

 

When to call an ambulance

You should always call an ambulance if:

  • this is the person’s first seizure as far as you are aware
  • the person has injured themselves beyond first aid
  • you suspect they may have inhaled food or liquid
  • the jerking lasts for five minutes or a longer time than is usual for that person
  • one seizure follows another with no recovery time in between
  • the person is having problems breathing after the seizure has stopped

 

First aid for absence seizures

Absence seizures used to be called petit mal epilepsy. When a person has an absence seizure, they lose consciousness for a short time.

They may look like they are in a daydream. They will stop what they are doing, blink and stare into space.

During the seizure the person will be unaware of their surroundings. The person will recover quickly and will not remember anything that happened during the seizure.

 

What to do if someone has an absence seizure

  • stay with the person
  • keep them safe
  • tell them what has happened

In part two of our first aid for seizures blog series we will be looking at first aid for tonic and atonic seizures and first aid for focal aware seizures also known as simple partial seizures.

For more information please check out our first aid for seizures factsheet by clicking here.