Seizure first aid: what to do when someone has a seizure

Seeing someone have a seizure can be frightening, especially the first time. The reassuring truth is that most seizures stop on their own within a few minutes and do not cause lasting harm. Knowing a few simple first-aid steps lets you keep the person safe until the seizure passes.

Stay calm, stay close, and time the seizure

Three basics apply to every type of seizure. First, stay calm — your steady presence helps the person and everyone around you. Second, stay with the person until the seizure ends and they are fully awake. Third, time the seizure. Check a clock or your phone as soon as it starts. Timing matters because a seizure that lasts longer than 5 minutes is a medical emergency. If other people have gathered, ask them to step back and give the person space and privacy.

Step by step during a tonic-clonic seizure

A tonic-clonic seizure is the kind most people picture: the person loses consciousness, their muscles stiffen, and their arms and legs jerk. Here is what to do:

1. Ease the person to the floor if they are sitting or standing, so they do not fall.
2. Gently turn them onto one side. This helps them breathe and lets saliva drain from the mouth.
3. Place something soft and flat under their head, such as a folded jacket.
4. Loosen anything tight around the neck — a tie, scarf, or buttoned collar — and remove glasses.
5. Move hard or sharp objects out of the way so the person cannot get hurt.

Then watch and wait. Most tonic-clonic seizures end on their own within one to three minutes.

The two big don’ts

Never restrain the person. Holding them down or trying to stop the movements will not shorten the seizure and can injure both of you.

Never put anything in the person’s mouth — not your fingers, not a spoon, not water or medication. It is a myth that someone can swallow their tongue during a seizure. Objects in the mouth can break teeth, cut the mouth, or block the airway. Wait until the person is fully awake and alert before offering food or drink.

Helping during non-convulsive seizures

Not every seizure involves convulsions. During some focal seizures (seizures that start in one area of the brain) or absence seizures (brief staring spells), the person may seem confused, stare blankly, wander, or fumble with objects. They may not respond when you speak to them.

Do not grab them or shout. Instead, speak calmly and guide them gently away from anything dangerous — traffic, stairs, water, or hot surfaces. Stay with them until they are fully aware again, then explain simply what happened.

When to call emergency services

Most seizures do not need an ambulance. Call your local emergency number right away if:

• It is the person’s first-ever seizure.
• The seizure lasts longer than 5 minutes.
• A second seizure starts before the person recovers from the first.
• The person is injured, has trouble breathing, or does not wake up after the jerking stops.
• The seizure happens in water.
• The person is pregnant or has a health condition such as diabetes or heart disease.

If you are unsure, it is always safer to call.

After the seizure

After a seizure, many people go through a recovery phase — doctors call it the postictal phase — and may feel tired, confused, sore, or embarrassed. Stay with the person, speak in short and reassuring sentences, and help them to a safe, comfortable place to rest.

If you can, note what you saw: when the seizure started, how long it lasted, what the movements looked like, and how the person felt afterward. These details are gold for the medical team. Logging them in a seizure diary app such as Epilepsy Mate makes it easy to share an accurate record at the next appointment and helps the care team spot patterns over time.

When to talk to your doctor

If you live with epilepsy, consider sharing these steps with family, friends, and coworkers so the people around you know what to do. Talk to your doctor if your seizures become longer, more frequent, or different from your usual pattern, if you are injured during a seizure, or if recovery starts taking longer than before. Caregivers can also ask the care team for a written seizure action plan that explains exactly when to give emergency help.