Seizures: proper first aid

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Seeing someone collapse and shake with convulsions is an impressive sight, and panic quickly sets in. However, the vast majority of seizures stop on their own within a few minutes. Knowing the right first aid steps for a convulsive seizure allows you to protect the person during the episode and avoid mistakes that could worsen it. Whether the seizure is related to epilepsy, high fever, trauma, or another cause, your role remains the same: secure, observe, and support.

Recognizing a convulsive seizure

A "generalized" convulsive seizure often occurs suddenly. The person may lose consciousness, fall to the ground, and then exhibit rhythmic and uncontrolled movements of the arms and legs. Sometimes body stiffness, noisy breathing, excessive salivation, or loss of bladder control are observed.

The person has no control over these movements and generally does not hear you during the seizure. It is neither painful nor dangerous in itself in most cases: the real risk comes from injuries caused by the fall and movements, as well as airway obstruction.

Proper first aid during the seizure

While the seizure is happening, stay calm and focus on immediate safety:

• Note the start time. This is the most important information: a seizure lasting more than 5 minutes becomes an emergency.
• Protect the head. Slip a soft object under the head (folded jacket, cushion) to prevent bumps against the floor.
• Clear the surroundings. Move away hard, sharp, or hot objects that could injure them.
• Loosen anything around the neck (collar, scarf, tie) to facilitate breathing.
• Stay with them and speak calmly, even if they don't seem to respond.

What you should never do

Some old beliefs are not only useless but downright dangerous:

• Do not put anything in their mouth — neither your fingers nor an object. It is impossible to "swallow your tongue," and you risk serious injuries or choking.
• Do not restrain their movements by force: you could cause fractures or muscle tears.
• Do not move the person, unless they are in a dangerous place (stairs, road, body of water).
• Do not give them water, food, or medication until they are fully conscious.

After the seizure: the recovery position

When the convulsions stop, the person is often confused, tired, or drowsy: this is normal. As soon as the movements stop and they are breathing:

• Gently turn them onto their side, into the recovery position, to allow saliva to drain and clear the airways.
• Stay with them until they have regained consciousness, and reassure them: they will probably not remember the episode.
• Ask onlookers to step back to preserve their privacy.

For detailed steps, consult our article on loss of consciousness and the recovery position.

When to call 911

Call emergency services immediately if:

• the seizure lasts more than 5 minutes, or a second seizure occurs without regaining consciousness;
• it is a known first seizure, or the cause is unknown;
• the person is injured, has difficulty breathing, or does not regain consciousness after the seizure;
• the seizure occurs in water, or in a pregnant, diabetic, or elderly person;
• you have any doubt.

What to remember

When faced with a convulsive seizure, your mission boils down to three words: protect, observe, support. Note the time, cushion the head, clear dangers, do not put anything in the mouth, then place the person on their side once the seizure is over. A well-stocked first aid kit and good first aid training help you react calmly when it counts. Also discover our first aid equipment to equip your home or workplace.

This article is for educational purposes only. In case of emergency, call 911.