A seizure is a sudden, uncontrolled electrical disturbance in the brain that temporarily alters a child’s awareness, movements, or behavior. Most seizures are brief and stop on their own without lasting harm. The immediate response of a caregiver is focused entirely on safety and injury prevention while the seizure runs its course. Understanding the proper first-aid steps is the most effective way to help a child during and immediately after a seizure.
Safety Measures During the Seizure
The primary goal during the seizure is to protect the child from physical harm, as the involuntary muscle contractions and loss of consciousness can lead to injury. As soon as seizure activity is recognized, the first step is to gently guide the child to the floor or a soft, safe surface, moving them away from any sharp objects, furniture, or stairs. If the child wears glasses, they should be removed quickly to prevent breakage or injury.
Once the child is on the ground, the next step is to position them gently onto their side, often called the recovery position. This positioning allows saliva or vomit to drain from the mouth, helping to keep the airway clear and reducing the risk of choking or aspiration. A soft, flat item, such as a folded jacket or small pillow, should be placed under the child’s head to provide cushioning.
It is important to loosen any tight clothing around the child’s neck, which may include collars, ties, or scarves, to ease breathing. Caregivers must resist the instinct to restrain the child’s movements or try to stop the seizure, as this will not halt the electrical activity and can cause musculoskeletal injuries. Never place an object into the child’s mouth, as this can cause injury to the teeth, gums, and jaw.
The single most important action during the seizure is to note the exact time the seizure activity begins and ends. Most seizures resolve spontaneously within one to two minutes, but the duration is necessary information for medical professionals. Caregivers should also observe the type of movements and physical changes, such as skin color, to report later.
Care and Monitoring After the Seizure Stops
The period immediately following the end of the seizure is known as the postictal phase, during which the brain recovers and the child gradually returns to their baseline state. The child should remain in the side-lying position until they are fully awake and alert, which continues to protect the airway. This phase can be marked by varying levels of confusion, drowsiness, or exhaustion, sometimes lasting from a few minutes to several hours.
Caregivers should gently check the child’s breathing and responsiveness once the seizure movements have completely ceased. It is common for children to be confused, disoriented, or even fall into a deep sleep. Providing reassurance and speaking in a calm, soothing voice is beneficial, as the child may be frightened or unaware of what has just occurred.
During this recovery time, carefully check the child for any injuries that may have occurred during the fall or the seizure activity. Injuries are most common around the head, mouth, or limbs. Do not offer the child any food, drink, or oral medication until they are completely awake and able to swallow without difficulty.
Knowing When to Call Emergency Services
While most seizures are self-limiting, certain signs indicate the need for immediate emergency medical attention. The most common trigger for activating emergency services is the duration of the seizure activity. A seizure that continues for five minutes or longer requires an immediate call to 911 or the local emergency number.
Immediate medical help is also required if the child has repeated seizures without regaining consciousness between the episodes. Difficulty breathing or signs of a bluish tint around the lips, tongue, or face after the seizure has stopped necessitates an emergency call. If the child was injured during the seizure, such as a head injury from a fall, emergency services should be contacted.
An ambulance should be called if the seizure occurred in water, such as in a pool or bathtub, due to the high risk of water aspiration. A first-ever seizure for a child warrants an emergency medical evaluation to determine the cause. If the child has a pre-existing medical condition like diabetes, or if they do not return to their normal level of responsiveness within a reasonable time, emergency personnel should be alerted.