The period immediately following a seizure is the post-ictal phase, a state of recovery where brain activity normalizes. This phase often involves confusion, drowsiness, and a temporary altered level of consciousness. As a rescuer, your focus is ensuring safety, maintaining a clear airway, and assessing the need for professional medical intervention. Remaining calm and acting quickly, but gently, is the best approach during this potentially disorienting time.
Prioritizing Safety and Positioning
Once the seizure activity stops, protect the person from secondary injury and maintain their ability to breathe. Gently turn the person onto their side into the recovery position. This allows gravity to drain any saliva or vomit from the mouth, preventing airway blockage. Continue cushioning their head with a soft item, like a jacket or pillow. Check the surrounding area for sharp objects, and never attempt to put anything into the person’s mouth.
Monitoring Recovery and Vital Signs
After safely positioning the person, monitor their physical state during post-ictal recovery. Observe their breathing pattern to confirm it is regular and not labored, as respiratory function can be temporarily compromised. Gently lifting the chin slightly can help keep the airway open. The person’s level of consciousness will likely be impaired, ranging from confusion to deep sleep. Note how long it takes for them to become responsive or regain baseline awareness, and check quickly for obvious external injuries.
Criteria for Calling Emergency Services
Most seizures are brief and resolve on their own without the need for emergency services. However, specific “red flags” mandate an immediate call to 911 or local emergency services. The primary criterion is a seizure that lasts five minutes or longer, a condition referred to as status epilepticus. This duration indicates that the brain’s electrical activity is failing to self-terminate and requires urgent medical intervention.
Emergency services must also be contacted if:
- A second seizure begins before the person fully regains consciousness.
- The person has difficulty breathing or does not wake up after the seizure has stopped.
- The person sustained a significant injury during the event, such as a serious head wound.
- The seizure occurred in water.
- The person is pregnant or has a known underlying medical condition like diabetes, as these factors complicate recovery.
Providing Comfort and Support During the Post-Ictal Phase
Once safety and emergency assessments are complete, the focus shifts to providing psychological and environmental support. The post-ictal phase often leaves the person confused, embarrassed, or disoriented. Speak to them in a calm, quiet, and reassuring voice to alleviate their distress as they regain awareness. Allow the person to rest and recover at their own pace, maintaining their privacy and discouraging unnecessary onlookers. Document the event details, including the seizure’s start and end times, and do not offer food or drink until they are fully alert and can swallow safely.