Seizures are common neurological events characterized by abnormal electrical activity in the brain that temporarily affects movement, sensation, or awareness. Witnessing a seizure can be distressing, and while intervention is instinctive, many people rely on outdated or dangerous first aid advice. Understanding correct safety protocols is paramount for preventing harm during these episodes.
Debunking the Myth
The definitive answer to whether you should place anything in a person’s mouth during a seizure is an unambiguous no. This outdated practice originated from the mistaken belief that a person could swallow their tongue during a convulsive seizure, leading to suffocation. Physiologically, swallowing the tongue is impossible because it is firmly attached to the bottom of the mouth by the lingual frenulum.
Although a person may bite their tongue or cheek during a seizure, the tongue cannot detach and be swallowed. During the seizure, the muscles of the body, including the jaw, contract powerfully and involuntarily. Trying to force an object between the teeth is highly dangerous due to this intense muscular contraction. The risk of harm from intervention significantly outweighs the risk of tongue biting, which is rarely severe or life-threatening.
Risks of Putting Objects in the Mouth
Placing any object, such as a spoon, wallet, or even a finger, into the mouth of a seizing person introduces serious and preventable risks. The powerful, uncontrolled clenching of the jaw muscles can easily result in broken or chipped teeth. This forceful action can also cause jaw dislocation or severe lacerations to the gums and surrounding mouth tissues.
If the object used is brittle, like plastic or wood, it can fracture inside the mouth, creating a choking hazard. Fragments of a broken object, or even a loosened tooth, can be inhaled, potentially obstructing the airway or leading to aspiration pneumonia. Furthermore, the rescuer is at significant risk of being severely bitten, as the person cannot control their bite reflex during the event.
Essential First Aid During a Seizure
The primary goal of seizure first aid is to protect the person from injury and allow the seizure to run its course naturally. For a generalized tonic-clonic seizure, gently guide the person to the floor if they are standing or seated. Immediately clear the surrounding area of any hard, sharp, or potentially harmful objects like furniture or debris.
Place something soft and flat, such as a folded jacket, cushion, or towel, beneath the person’s head to cushion it from the hard surface. Loosen any restrictive clothing around the neck, such as a tie or collar, to ensure easier breathing. It is important to avoid attempting to restrain the person or stop the movements, as this can lead to serious musculoskeletal injuries like fractures or dislocations.
Time the seizure from the moment the convulsive movements begin. Staying with the person and observing the characteristics of the seizure provides valuable information for medical professionals. Once the active shaking phase has ended, the person should be gently rolled onto their side into the recovery position.
Recovery and When to Seek Emergency Help
Once the active seizure movements have stopped, the person should be gently rolled onto their side. This recovery position involves extending the arm closest to the ground, placing the other hand under the cheek, and bending the top leg at the knee. Positioning on the side helps saliva, vomit, or other fluids drain from the mouth, preventing the tongue from falling back and obstructing the airway.
Monitoring the person’s breathing is important, but breathing typically resumes normally once the seizure concludes. During the post-ictal phase, the person may be confused, drowsy, or disoriented. Offer calm reassurance as they regain full awareness. Do not offer any food or drink until they are fully alert and oriented, to prevent the risk of aspiration.
Emergency medical services should be called immediately if the seizure lasts five minutes or longer.
Criteria for Calling 911
- The person has difficulty breathing or fails to wake up after the seizure ends.
- The person is injured during the seizure.
- It is the person’s first-ever seizure.
- The person is pregnant or has a pre-existing condition like diabetes or heart disease.