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SEIZURE FIRST AID

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There are several kinds of seizures; they all look different, and they require different kinds of first aid.  In general, if a child or an adult begins to have a seizure, below are some guidelines on what to do:

1.  Help the person lie on the floor, placing him or her on their side.  

During a seizure, a person is unable to control his/her movements and posture. Lying on the floor minimizes the risk of physical injury. Also, an individual will often vomit during a seizure episode. Laying them on their side prevents choking. Make sure to move objects away that are potentially dangerous to the individual (sharp objects, glass, etc.).

2.  Do not put anything in the person’s mouth.  

It is a common belief that an individual may swallow their tongue during a seizure. Although it is possible that a person may bite their tongue, this rarely, if ever, causes serious injury. On the other hand, the human jaw is very powerful, and people have bitten off spoons, sticks and other objects during a seizure. In addition, placing anything in the person’s mouth poses a greater danger of choking.

3.  If the seizure activity lasts more than five minutes, call for paramedics.

Most seizures are brief and self-limited, but they occasionally do last longer. If you have a rectal medication (i.e. Diastat®) available, administer it as directed. Do not attempt to administer medications by mouth! A person is unable to swallow during a seizure and will most likely choke if something is placed in the mouth (as mentioned above).

4. Check to see if the individual has a medical I.D. bracelet or necklace that says “epilepsy” or “seizure disorder.” 

Some individuals wear a medical I.D. bracelet or necklace to help other people know that they are being treated for seizures.  Often, the I.D. will have a list of the medication(s) on the back of the I.D. so that health care professionals will know immediately what medications the person uses to treat the seizure disorder. 

5. Try to remain calm.

Remember that most seizures are brief and self-limited, and the individual is rarely in danger. However, if at any time there is concern for someone’s safety, call for help. Speak softly and reassuringly to the person having a seizure and offer them help until the seizure ends.  Stay with the person until he or she is completely awake and aware again.

6. There are some special things to remember if a seizure occurs while the individual is in the water (in the bathtub or while swimming). 

You should support the person having a seizure in the water, and make sure their head is tilted so the face and head stay above the surface of the water.  Help them to get out of the water as soon as possible.  Once on dry land, make sure they are breathing.  If not, begin rescue breathing at once and call 911.  Anyone who’s had a seizure while in the water should go to the emergency room for a checkup, even if he or she seems to be alright afterward.  If a lot of water was swallowed, there could be damage to the heart and lungs.

When should you call 911?

You should call 911 when:

• You have no way of knowing whether or not the person has epilepsy. 
• The person having a seizure does not have epilepsy because it could be a sign of a serious illness. 
• The person having a seizure is pregnant, has diabetes, is injured in some way, or appears to be ill.  
• The seizure goes on longer than five (5) minutes. 
• Another seizure starts right after the first one ends. 
• The person has trouble breathing, seems hurt, or is in pain.  
• The person isn’t getting back to normal the way he or she usually does following a seizure.

You do not need to call 911 if:

• The seizure ends after a couple of minutes; 
• The individual wakes up and starts breathing normally again; and 
• Is fully awake and aware after a short rest.

Written by Elizabeth Thiele, Ph.D., M.D., Director of the Carol and James Herscot Center for TSC and Director of the Pediatric Epilepsy Program, Massachusetts General Hospital, Boston, Massachusetts, and an assistant professor at Harvard Medical School.

**Tuberous Sclerosis Alliance “Information Sheets” are intended to provide basic information about TSC. They are not intended to, nor do they, constitute medical or other advice. Readers are warned not to take any action with regard to medical treatment without first consulting a physician.  The TS Alliance does not promote or recommend any treatment, therapy, institution or health care plan. 

Made possible through an educational grant from the Schnurmacher Foundations.  June 2006