A generalized seizure, often recognized as a convulsion, involves the entire brain, causing a person to lose consciousness and experience rhythmic, involuntary muscle jerking and stiffening. When witnessing this event, a common but misguided instinct is to intervene in the person’s mouth to prevent them from “swallowing their tongue.” However, the definitive answer is no. This action is unnecessary and can cause serious harm to both the person seizing and the rescuer.
Debunking the Myth: The Dangers of Intervention
The fear of a person swallowing their tongue is based on a persistent misconception, as it is anatomically impossible. The tongue is firmly anchored to the floor of the mouth by the lingual frenulum, preventing it from being fully swallowed. The actual concern is that the tongue may relax and fall backward, potentially blocking the airway if the person is lying on their back.
Inserting objects (such as a spoon, pen, or towel) or fingers into the person’s mouth is dangerous and must be avoided. The powerful, involuntary clenching of the jaw during a seizure can easily cause severe injury, including broken teeth, jaw dislocation, or internal mouth trauma. Any foreign object forced into the mouth can also become a choking hazard, obstructing the airway. Furthermore, the rescuer risks a severe bite injury, as a seizing person has no control over their jaw muscles.
Essential Seizure First Aid: What to Do Instead
Instead of intervening in the person’s mouth, the primary goal of seizure first aid is to protect the person from injury and monitor the event. The initial step is to stay calm and begin timing the duration of the seizure immediately. Most seizures will stop naturally within a few minutes, usually lasting less than three minutes.
Clear the immediate area around the person of any hard or sharp objects that could cause injury during the rhythmic shaking. Gently ease the person to the floor, and place something soft and flat, like a folded jacket or small pillow, under their head to cushion it. Also, loosen any tight clothing around the neck, such as a collar or tie, to ease breathing.
Once the area is safe, gently roll the person onto one side into the recovery position. This position allows saliva, vomit, or other fluids to drain from the mouth, which helps keep the airway clear. Do not restrain the person or try to stop their movements, as this will not stop the seizure and can result in muscle or bone injuries. After the seizure ends, stay with the person, offer reassurance, and speak calmly as they regain consciousness, which may take several minutes.
Critical Situations: When to Call for Emergency Help
While the majority of seizures resolve on their own without requiring emergency medical services, certain conditions elevate the event to a medical emergency. You must call 911 or local emergency services if the seizure lasts longer than five minutes, as this duration increases the risk of a condition known as status epilepticus. A call is also warranted if the person has a second seizure immediately following the first one without regaining full consciousness in between.
Emergency intervention is also required in several other situations:
- If the person is significantly injured during the seizure, such as sustaining a head wound.
- If the person is pregnant or has a known underlying health condition like diabetes or heart disease.
- If the seizure occurs in water, such as a pool or bathtub, due to the risk of water inhalation.
- If this is the person’s first-ever seizure, as medical evaluation is necessary to determine the cause.