A seizure is a sudden, uncontrolled surge of electrical activity within the brain. When witnessing a seizure, immediate, informed action is necessary because the primary goals are to prevent injury and to protect the person’s airway. Understanding the correct steps to take during and after the event can significantly reduce the risk of complications, especially those related to breathing difficulties.
Protecting the Person During the Seizure
The first priority upon recognizing a seizure is to keep the person safe from their immediate surroundings. Quickly look around the area and gently clear away any furniture, sharp corners, or hard objects that the person could strike during convulsive movements. If the person is on a hard surface, slide something soft and flat, such as a folded jacket or towel, beneath their head to provide cushioning.
Loosen any restrictive clothing around the neck, such as a tie or collar, to prevent any potential airway obstruction. Begin timing the seizure as soon as possible, as the duration is an important piece of information for medical professionals. Never attempt to restrain the person’s movements or place any object into their mouth, as this can cause injuries like broken teeth or jaw damage.
Positioning for Airway Safety
The most important physical action is to gently roll the person onto their side. This positioning utilizes gravity to allow saliva, mucus, or any vomit to drain from the mouth, preventing the fluid from entering the trachea and lungs. It is advised to perform this maneuver once the active, convulsive movements have slowed or stopped to avoid causing harm.
Performing the Roll
To perform the roll, kneel beside the person and ensure the arm nearest to you is placed at a right angle to their body, with the elbow bent and the palm facing upward. Next, take the person’s other arm and bring their hand across their chest, placing the back of their hand against the cheek nearest to you. Use your other hand to reach across to the knee furthest from you and pull it up so the foot is flat on the floor.
Use the bent knee as a lever and gently pull it toward you, rolling the person onto their side, with their head supported by the hand you placed on their cheek. The bent leg acts like a kickstand to keep them stable and prevent them from rolling back onto their stomach or back. Slightly tilting the head back by gently raising the chin can further help to open the airway.
Actions After the Seizure Stops
Once the active seizure movements have fully ceased, the person will enter the postictal phase. They may be confused, drowsy, or unresponsive. Continue to monitor their breathing and responsiveness, remaining with them until they are fully awake and aware of their surroundings. Speak calmly and offer reassurance, as they may be disoriented and frightened by the experience.
Emergency medical services should be called immediately if the seizure lasts longer than five minutes, or if a second seizure begins before the person has recovered from the first. Other criteria for calling for immediate help include:
- If the person appears to have difficulty breathing after the movements stop.
- If the seizure occurred in water.
- If the person is known to be pregnant or have a condition like diabetes.
- Any first-ever seizure.
- A seizure that results in significant injury.
- One where the person does not regain consciousness within a few minutes.