A seizure in the classroom is a temporary electrical disturbance in the brain that most often resolves on its own within a few minutes. This sudden, uncontrolled burst of activity can manifest in various ways, from a blank stare to full-body convulsions. Although the sight of a child having a seizure can cause panic, most events are brief and manageable with appropriate first aid. The immediate response from a teacher or staff member must focus on safety and injury prevention. Understanding the clear steps to take during and after a seizure is the most effective way to provide calm, competent care.
Immediate Safety Measures During the Event
The moment a child begins seizing, check the time, as the duration of the event is important medical information. Most seizures conclude naturally within one to three minutes, but timing helps determine if emergency medical services are necessary. The priority is to protect the child from injury by clearing the immediate vicinity of hard or dangerous objects like desks and chairs.
Gently ease the child to the floor and place something soft, such as a folded jacket, beneath their head to prevent trauma from jerking motions. Turn the child gently onto their side (the recovery position). This position allows saliva or vomit to drain from the mouth, keeping the airway clear and preventing aspiration.
Avoid placing anything into the child’s mouth, including fingers or objects, as this can cause dental injury or obstruct the airway. Do not attempt to restrain the child or hold down their limbs, as this will not stop the seizure and could result in musculoskeletal injury. Loosen any restrictive clothing around the neck, such as a tight collar or tie, to aid breathing.
Monitoring and Post-Seizure Recovery
Once the physical movements cease, the child enters the postictal phase. Continue to monitor the child’s breathing and keep them in the side-lying position until they regain full consciousness. The postictal state can involve the child being confused, drowsy, or agitated, lasting anywhere from a few minutes to an hour.
Staff should speak to the child calmly and reassuringly as they begin to wake up and orient to their surroundings. Do not offer the child any food, water, or oral medications until they are fully alert, as there is a risk of choking or aspiration.
Documentation of the event is important for medical professionals. Record specific details, including the exact start and stop time, a description of the movements observed, and the child’s postictal condition. This information, along with any known seizure triggers, helps parents and physicians manage the child’s care.
Emergency Criteria for Contacting 911
While most seizures are self-limiting and resolve quickly, certain situations require immediate activation of emergency medical services (EMS) by calling 911.
Call 911 immediately if:
- The seizure lasts longer than five minutes (the standard threshold for a prolonged event).
- The child stops breathing or appears to have trouble breathing after the movements have stopped.
- A second seizure begins immediately after the first one ends (a form of status epilepticus).
- The seizure occurs while the child is in water, such as a pool.
- The child does not regain consciousness or responsiveness after the seizure concludes.
- An injury is sustained during the fall or the seizure itself, such as a head injury or fracture.
- It is the child’s first-ever seizure, or if the child has a known underlying condition like diabetes and loses consciousness.
Preparation and Communication Protocols
Effective seizure management in a school environment begins with proper preparation and planning. For children with a known seizure disorder, a personalized Seizure Action Plan (SAP) is essential. The SAP, developed collaboratively by parents, physicians, and school staff, provides specific instructions tailored to the child’s unique seizure type, emergency medication protocols, and individualized response criteria.
The school nurse or designated staff should serve as the custodian of the SAP, but key personnel, including the classroom teacher, must have ready access to a copy. Staff training is recommended to ensure they know how to administer first aid and, if applicable, emergency rescue medications specified in the plan.
Following the seizure event, immediate notification should follow an established hierarchy, starting with the school nurse and administration, followed by the child’s parents or guardians. The teacher should calmly direct classmates away from the child or assign another adult to escort them. This maintains privacy for the seizing child while allowing the responding adult to focus entirely on providing care.