Seizures are probably more common than you think. The CDC says about 10% of Americans will have at least one during their lifetime. If you know how to give the proper seizure first aid, you might be able to help someone having a seizure.
What Does a Seizure Look Like?
There are many types of seizures, but what most people think of is the tonic-clonic seizure. Formerly known as grand mal seizures, tonic-clonic seizures are classified as generalized-onset seizures. That's because they affect both sides of the brain at the same time. They can be scary to watch, and someone who has one rarely knows or remembers what's happening. The seizing usually goes through a few phases.
The tonic (which means stiffening) phase starts first. During this:
- The person seems to "check out."
- Their muscles clench and become rigid.
- They're likely to lose consciousness and fall.
- They also might bite their tongue or cheek, causing bleeding.
The clonic (which means rhythmical jerking) comes next. In this phase:
- Their arms and maybe legs start to jerk and bend, relaxing at their elbows, hips, and knees, slowing and stopping after a few minutes.
- They may have trouble breathing, which can make their face look a bit blue.
- They might also lose control of their bladder or bowels.
- They'll slowly return to consciousness and become more aware after about one to three minutes.
Generalized-onset seizures can be dangerous because the person is unaware of their surroundings and can't protect themselves from harm. The uncontrolled thrashing raises their chances of getting hurt.
Focal seizures are different; they start in one area on one side of the brain, so they may be less intense and usually last no more than a minute or two.
There are two types of focal seizures:
- Focal onset aware seizures: The person doesn't lose their awareness.
- Focal impaired awareness seizures: The person does lose their awareness.
Seizure First Aid: What Can You Do?
If you have a family member or friend who has seizures, knowing basic seizure first aid could save their life in a medical emergency. Your goal during seizure first aid is just to keep the person safe and call for help if needed. You can remember how to give seizure first aid with the 3 S's of seizures: STAY, SAFE, and SIDE.
What to do when someone is having a seizure
- STAY with the person and start timing the seizure from beginning to end. Check for a medical alert bracelet, and remain calm.
- Keep the person SAFE by moving them away from dangerous objects or situations (such as traffic if they're still conscious).
- Turn them on their SIDE with their mouth pointing toward the ground if they're not awake and unaware. Make them comfortable; lay them down on the floor if necessary.
What not to do when someone is having a seizure
- Don't put anything in their mouth, like a spoon or tongue depressor.
- Don't give them water or medication.
- Don't restrain them.
- Don't leave them alone. Stay with them until they're awake and alert and can answer normally when you talk to them.
Emergency Medication for Seizures
Not all seizures are the same, and neither are the people who have them. So, treatment plans vary from person to person. But there are medications, commonly referred to as "rescue medications," that can be given to help stop a seizure quickly in emergencies.
Depending on the circumstance, these rescue medications can be given:
- Nasally
- Orally
- Under the tongue to dissolve
- Between the cheek and the gum to dissolve
- Rectally
The most commonly used medications are from a group of medicines called benzodiazepines. They enter the bloodstream quickly and start working to stop the seizure. They include:
- Diazepam (Valium)
- Lorazepam (Ativan)
- Midazolam (Versed)
Nasal spray midazolam (Nayzilam) and diazepam (Valtoco), as well as rectal diazepam gel (Diastat), are FDA-approved for people who have repetitive seizures.
When to Call 911
When someone has a seizure, you usually don't have to call for emergency help. But you should call 911 if:
- The seizure lasts longer than five minutes.
- Another seizure begins soon after the first.
- The person doesn't "wake up" after the movements have stopped.
- The person gets injured during the seizure.
- The seizure happens in water.
- The person who has the seizure is pregnant.
- It's the first time the person has had a seizure.
If you're concerned that something else may be wrong, or the person has another medical condition such as heart disease or diabetes, call a doctor.
Seizure First Aid FAQs
What to do when someone is having a diabetic seizure
People who have diabetes can have an emergency if their blood sugar gets too low (hypoglycemia) or too high (hyperglycemia). Both can be potentially fatal. So, if you see someone having a diabetic seizure, the first thing you should do is call 911 right away. If their blood sugar is severely low, don't try to inject them with insulin because this can make it drop even further. And don't give them food or drink because they can choke. If they have a nasal or injectable version of glucagon, try giving that. If the seizure is because their blood sugar is severely high, keep them calm and wait for emergency responders. Treating hypoglycemia requires proper care from doctors to safely lower blood sugar so that it's not lowered too quickly.
What to do if you have a seizure alone
If it's the first time you've ever had a seizure or if you pass out during a seizure, call 911 when you're able and see a doctor right away.
Should you sleep after a seizure?
It's OK to sleep after a seizure. It gives your body and brain time to rest and recover.
