A tonic-clonic seizure involves a loss of consciousness and widespread muscle contractions. During this type of seizure, an individual typically experiences a rigid tensing of the body, known as the tonic phase, followed by rhythmic jerking movements, which is the clonic phase. Understanding how to react, and more importantly, how not to react, can significantly influence the safety and well-being of the person. This article guides observers on specific actions to avoid when someone is undergoing a tonic-clonic seizure, ensuring a safer environment.
Actions to Avoid During a Tonic-Clonic Seizure
Attempting to restrain an individual during a tonic-clonic seizure can cause harm. Forcing a person to stop convulsing can lead to musculoskeletal injuries, such as dislocated joints or broken bones, for both the person having the seizure and the helper. The uncontrolled muscle contractions are part of the seizure process and cannot be voluntarily stopped.
Do not place anything in the person’s mouth. A common misconception is that someone might swallow their tongue, but inserting objects like spoons, wallets, or fingers is dangerous. This action can cause severe injuries, including broken teeth, lacerations to the gums and tongue, or even block the airway, leading to choking.
Avoid moving the person during a seizure unless they are in immediate danger, such as near a busy road, at the top of a staircase, or in deep water. Unnecessary movement can result in further injury if they are dropped or hit objects. Instead, protect the individual from their surroundings by gently guiding them away from hazards and placing something soft under their head, like a folded jacket, to prevent head injuries.
Mistakes to Avoid After a Seizure
After a tonic-clonic seizure, the individual typically enters a post-ictal state, characterized by confusion, disorientation, and fatigue. Do not leave the person alone immediately, as they remain vulnerable and require supervision. Staying with them provides reassurance and ensures their safety as they gradually regain full awareness.
During this recovery period, the person may appear drowsy or unresponsive, and their swallowing reflex might not be fully functional. Offering food or drink too soon can pose a choking hazard or lead to aspiration. Wait until the individual is fully alert and clearly able to swallow before offering any sustenance.
Avoid rushing the person to stand up or move around immediately after a seizure. Their body needs time to recover, and forcing movement can lead to falls or further disorientation. Allow them to rest and regain their bearings at their own pace, offering a calm and quiet environment.
Do not question the individual aggressively or expect immediate, coherent responses. The confusion and memory impairment experienced in the post-ictal state are temporary effects of the seizure. Patience and a gentle demeanor are important, as pressing them for answers can cause distress and agitation.
When Not to Hesitate: Seeking Emergency Care
While most tonic-clonic seizures resolve within a few minutes, certain situations warrant immediate emergency medical attention. Call emergency services if the seizure lasts longer than five minutes, as prolonged seizures can lead to complications. Also call if the person experiences difficulty breathing or stops breathing after the seizure has concluded.
Seek emergency care if this is the person’s first seizure, to determine the underlying cause and initiate appropriate medical management. Also call if the individual sustains an injury during the seizure, such as a head injury or a broken bone. A second seizure immediately following the first, without full recovery, also requires urgent medical assessment.
Specific circumstances also warrant emergency care, such as if the seizure occurs in water, increasing the risk of drowning. If the person has a known medical condition like diabetes or is pregnant, contact emergency services due to increased risks.