Epilepsy Resources

First Aid for Seizures

It’s important to know that generalized absence seizures and focal aware seizures do not require first aid. However, first aid is vital for generalized tonic-clonic seizures and focal impaired awareness seizures.

Click below to learn more about first aid for seizures.

First Aid for Generalized Tonic-Clonic Seizures

View the first aid steps for generalized tonic-clonic seizures below, or download a first aid poster here.

Stay calm and track time
Check for epilepsy or seizure disorder ID (bracelet, necklace)
Protect from possible hazards (chairs, tables, sharp objects, etc.) and allow the body to move freely
Turn the person on his or her side to keep the tongue from blocking the airway and allow saliva to drain from the mouth
Cushion head with a soft object or the palm of your hand, and make sure it is not covering the mouth or nose and hampering breathing
If necessary, remove eyeglasses and loosen tight neckwear
After the seizure, remain with the person until he or she regains full awareness of the surroundings (ask simple questions like, “What is your name?”)
Provide emotional support
Document seizure activity

For people in wheelchairs, the first aid is the same with these additional steps:

Try to keep the person in the wheelchair if possible
Secure the wheelchair, and fasten the seatbelt loosely to prevent the person from falling

First Aid for Focal Impaired Awareness Seizures

View the first aid steps for focal impaired awareness seizures below, or download a first aid poster here.

Stay calm and track time
Check for epilepsy or seizure disorder ID (bracelet, necklace)
Gently direct the person away from hazards or physically block the hazards yourself (stairwells, furniture, sharp objects, etc.)
Do not restrain the person
Do not expect the person to obey verbal instructions
After the seizure, remain with the person until he or she regains full awareness of the surroundings (ask simple questions like, “What is your name?”)
Provide emotional support
Document seizure activity

Rescue Medications

Rescue medications are prescribed for seizure clusters and prolonged seizures. If a person has been prescribed a rescue medication, a seizure response plan is vital so that people know how to best care for that person during and after a seizure. Doctor’s orders must be strictly followed. Download a seizure response plan template here.

Emergency protocol should include:

Medication name
How and when it should be given
Specific administration instructions
What to do following administration

Make sure to monitor the person’s responses and side effects after administering the rescue medication.

There are several available rescue medications, including a rectal gel and nasal sprays.

Diastat rectal gel is mostly used for children who are having seizure clusters or prolonged seizures. It has been approved by the FDA for use by parents and non-medical caregivers. State regulations often govern use in facilities. It’s important to note that you should use the entire contents of the syringe to avoid under-dosing someone.
Nayzilam and Valtoco are two nasal forms of benzodiazepines that have been approved by the FDA to treat people who have two or more seizures in a 24-hour period. Nayzilam is for people 12 years of age and older. Valtoco is for people 6 years of age and older. These nasal sprays can be given easily outside of a medical setting by non-medical people.

What NOT to Do

The following things are dangerous to do when someone is having a seizure, so do NOT do them.

Do NOT put anything in a person’s mouth during a seizure. It is physically impossible to swallow your tongue, and inserting something in the person’s mouth could potentially break teeth, injure the jaw, or block the airway.
Do NOT hold down or restrain a person during a seizure. Restraining someone during a tonic-clonic seizure can cause spraining or breaking of body parts. Restraint during a focal impaired awareness seizure can cause an aggressive response because the brain perceives unwanted restraint as an attack. As a result, the person could become combative.
Do NOT attempt to give oral medications (other than a seizure rescue medication), food, or drink during the post-ictal or post-seizure phase.

When is a Seizure an Emergency?

Most seizures are NOT medical emergencies. However, call 911 in the following situations:

It is the person’s first-time seizure or if you’re unsure if the person has a history of seizures
A seizure lasts longer than five minutes
The person is experiencing repeated seizures without regaining consciousness
The person is injured, has diabetes, or is pregnant
A seizure occurs in water
Normal breathing does not resume
An emergency evaluation is requested by the person

Two documents that will greatly assist in first aid are a seizure response plan and a seizure observation record.

A seizure response plan is so valuable for people with seizures because it creates a profile of an individual’s seizure information. Seizures can vary from person to person, so a seizure response plan lets others know all about that particular person’s seizure disorder. A seizure response plan should include the following information:

Contact information (including emergency contacts)
Seizure information (type, symptoms, length, frequency)
Any known triggers
Basic first aid information
Seizure emergencies
Seizure medication and treatment information
Special considerations and precautions

Download a seizure response plan template here. There’s a place on the form for a healthcare provider to sign. Getting that signature is important because it really validates that document and reinforces its accuracy.

A seizure observation record is a document that should be filled out immediately after a person has a seizure by someone who witnessed the seizure. This record will help the person and their loved ones share the seizure information with their doctor. If the doctor has these details, he or she can better help the person receive the best care and treatment for their individual condition. A seizure observation record should include the following information:

Name
When the event occurs: note date, time, and length
Behavior before the seizure; possible triggers
Parts of the body involved
Conscious: (yes/no/altered)
Injuries: briefly describe
What happens post-seizure (how long it took the person to recover)

It is best to write down what happens as soon as possible so that you do not forget any important details. Download a seizure observation record template here.