A seizure is a sudden, temporary burst of abnormal electrical activity within the brain’s nerve cells, leading to involuntary changes in movement, behavior, or awareness. These episodes are often brief and resolve on their own, but they can be frightening for parents and caregivers to witness. Knowing the correct, immediate steps to take is the most effective way to protect a child from harm. This guide provides a clear, actionable framework for immediate response, outlining steps to take during the seizure, the criteria for calling emergency services, and the necessary care afterward.
Essential Steps During a Seizure
The immediate priority when a child is having a seizure is to ensure their physical safety and prevent injury. Gently help the child to the floor or a soft surface, away from any hard or sharp objects that could cause harm. Place something soft and flat, such as a folded jacket or blanket, under their head to provide cushioning and protect them from repeated impact.
Turn the child gently onto their side into the recovery position. This helps keep the airway open and allows any saliva or vomit to drain out. Loosen any tight clothing around their neck, such as a collar or tie, to aid in breathing. Note the exact time the seizure begins and keep timing its duration.
Do not attempt to stop the movements or force anything into the child’s mouth. Trying to restrain the child can cause injury. Inserting objects or fingers into the mouth can cause injuries to the teeth, jaw, or the person assisting, and there is no risk of a child swallowing their tongue during a seizure.
Emergency Situations Requiring 911
While most seizures are short and stop without intervention, specific situations require immediate emergency medical assistance. The most important criterion for calling 911 is if the seizure lasts longer than five minutes. This duration is the recognized threshold for status epilepticus, which requires urgent medical intervention.
Immediate emergency services must also be contacted if the child has trouble breathing or appears to be turning blue, indicating a problem with oxygenation. Call 911 if the child is injured during the seizure, such as from a fall, or if they have a second seizure immediately after the first without regaining consciousness. Any seizure that occurs while the child is in water carries a high risk of drowning and warrants an emergency call.
A child’s first-ever seizure is a reason to seek immediate medical evaluation, typically via the emergency room. Even if the seizure stops quickly, first-time seizures require a medical workup to determine the underlying cause. Call 911 if the child does not wake up or return to their normal behavior within a few minutes after the movements have stopped.
Post-Seizure Care and Monitoring
Once the seizure activity has fully stopped, the child will enter the post-ictal phase, characterized by confusion, drowsiness, and sometimes sleep. This phase is a normal part of the brain recovering from the electrical overactivity. Continue to ensure the child is resting comfortably on their side until they are fully awake and aware of their surroundings.
Stay with the child and offer calm reassurance, as they may be disoriented or upset and not remember what happened. Gently check the child for any injuries they may have sustained during the seizure, such as bumps or bruises from a fall. Allow the child to rest as long as they need to, as the seizure can be physically exhausting.
It is highly beneficial to document the entire event for the child’s medical provider. Record details such as the exact duration, the nature of the movements, whether any loss of bladder or bowel control occurred, and the time it took for the child to return to normal awareness. This detailed information is important for diagnosis and the development of a future seizure action plan.