A seizure represents an episode of abnormal electrical activity in the brain that temporarily disrupts normal function, leading to changes in movement, behavior, or consciousness. Witnessing this sudden, uncontrolled event can be unsettling for a caregiver. Understanding the correct, immediate steps to take during and after a seizure is paramount to ensuring the child’s safety and providing accurate information to medical professionals.
Immediate Safety Steps During the Seizure
The primary concern while a seizure is actively occurring is preventing the child from sustaining an injury. Most seizures resolve spontaneously within a few minutes, meaning the caregiver’s role is protective until the electrical surge subsides. As soon as the seizure begins, immediately start timing the event, as the duration is a significant factor in determining the need for emergency medical services.
If the child is standing or seated, gently ease them to the floor or ground to prevent a fall that could cause severe injuries. Clear the area immediately surrounding the child of any hard, sharp, or dangerous objects, such as furniture corners or glassware. Place something soft and flat, like a folded jacket or small blanket, under the child’s head to cushion it from the rhythmic impact of convulsions.
As soon as possible, gently turn the child onto their side, which is known as the recovery position. This positioning allows saliva or vomit to drain from the mouth, helping to keep the airway clear and minimizing the risk of aspiration. Furthermore, any tight clothing, especially around the neck, should be loosened to ease breathing.
Avoid restraining the child’s movements. Attempting to hold down the child or stop the shaking will not halt the seizure and may result in injury to the child or the caregiver. Never put anything into the child’s mouth, including fingers, spoons, or medicine. The child cannot swallow their tongue, and forcing the mouth open can cause severe injury to the teeth, jaw, or gums, and may obstruct the airway.
Emergency Criteria: When to Seek Urgent Help
While most seizures stop on their own, certain conditions require immediate medical attention. The most critical threshold for calling 911 is if the seizure activity lasts for five minutes or longer. A prolonged seizure, medically termed status epilepticus, requires immediate intervention to prevent potential complications.
The child’s breathing status is an important indicator for emergency escalation. Call for urgent help if the child appears to stop breathing, has difficulty breathing, or if the skin, lips, or face begin to turn blue or dusky, which are signs of oxygen deprivation. Emergency services should also be contacted if the child has repeated seizures without regaining consciousness or responsiveness in between the events.
A first-ever seizure in a child is always considered a medical emergency, even if it is brief and resolves quickly. If the child sustained a severe injury during the episode, such as head trauma from a fall, emergency medical personnel should be involved. A seizure that occurs while the child is in water, such as a bathtub or pool, also necessitates an immediate 911 call due to the risk of drowning or aspiration.
What to Do After the Seizure Ends
Once the seizure activity has completely stopped, the child enters the recovery phase, known as the postictal state. During this time, the brain is recovering from the intense electrical discharge, and the child’s level of consciousness will likely be altered. Check the child’s breathing and responsiveness immediately after the movements cease, ensuring the airway remains clear.
The child should be kept on their side in the recovery position until they are fully awake and alert. This helps manage potential confusion and prevents the aspiration of secretions. It is common for a child to be confused, drowsy, or extremely tired for a period ranging from a few minutes to an hour or more following a seizure. They may also experience temporary symptoms like a headache, nausea, or muscle soreness.
Offer calm reassurance and allow the child to rest in a quiet, safe environment. Do not offer food or drink until the child is completely awake and can swallow normally, as they are at risk for choking while confused. If the child has a known seizure disorder and a rescue medication is prescribed, follow the physician’s specific instructions regarding when and how to administer it during the postictal period.
Documentation is important once the child is safe and resting. Record the precise duration of the seizure, noting the time the activity started and stopped, using the timer initiated at the beginning. Details about the event, including the child’s initial symptoms, the type of movements observed, and any potential triggers, should be written down for the physician. This information is essential for accurate diagnosis and for managing the child’s ongoing medical care. If the seizure was not an emergency, contact the child’s primary care provider or neurologist promptly for a follow-up appointment.