Seizure First Aid

Witnessing a seizure can be frightening. Knowing what to do — and what not to do — makes a real difference. Most seizures stop on their own within 1–3 minutes.

Call 999 If:

  • The seizure lasts more than 5 minutes
  • The person has another seizure immediately after
  • The person does not regain consciousness within 5 minutes after the seizure stops
  • It is their first known seizure
  • The seizure happens in water
  • The person is injured during the seizure
  • The person is pregnant
  • You are unsure of the reason for the seizure
✍️ Paurav Joshi, Director, Ekvarta Ltd 📅 Last updated: May 2026

What to Do During a Convulsive (Tonic-Clonic) Seizure

  1. 1

    Stay Calm and Note the Time

    Start timing the seizure the moment it begins. Stay calm — your calmness will help others around you and help you respond correctly. The person cannot hear or respond during the seizure.

  2. 2

    Protect from Injury

    Clear hard, sharp or hot objects away from the person. If possible, cushion their head with something soft (a folded jumper, a pillow). Do not try to move them unless they are in immediate danger (e.g., near a road or in water).

  3. 3

    Do NOT Restrain or Put Anything in Their Mouth

    Never try to hold the person still or stop the jerking movements — you could injure them or yourself. Never put anything in their mouth — they cannot swallow their tongue. This is a myth. Putting things in their mouth causes serious injury.

  4. 4

    When Convulsions Stop — Recovery Position

    Once the jerking stops, carefully roll the person onto their side into the recovery position. This keeps the airway clear of saliva. Support their head. Stay with them.

  5. 5

    Stay with Them Until Fully Recovered

    Talk calmly and reassuringly. The person will likely be confused, drowsy or distressed after the seizure (the "postictal" phase). This can last minutes to hours. Reassure them that they are safe and tell them what happened.

  6. 6

    Record the Seizure

    Note the time, duration, type of movements and anything that happened before the seizure. If the person has a seizure diary, record in it. This information is valuable for the neurologist.

Emergency Rescue Medication

Some people with epilepsy carry emergency rescue medication (midazolam buccal liquid or diazepam rectal solution) for use when a seizure lasts longer than 5 minutes or as specified in their Seizure Action Plan.

This medication should only be given by someone trained to administer it and only according to the person's Seizure Action Plan. Carers must receive specific training before administering rescue medication.

Non-Convulsive Seizures

Not all seizures involve convulsions. Other types require a different response:

Absence Seizures

The person stares blankly for a few seconds and is unresponsive. Do not shout at or shake them. Stay with them and let the seizure pass. Gently reorient them afterwards.

Focal Seizures

May involve repetitive automatic movements, confusion, or strange sensations. Do not restrain. Gently guide the person away from danger if needed. Stay with them until awareness returns fully.

Drop Attacks (Atonic)

Sudden loss of muscle tone causing collapse. Injury is common. Check for head injury after any drop attack. Helmets may be recommended for people with frequent drop attacks.

Myoclonic Jerks

Brief, sudden muscle jerks — often in the morning. Usually short. Ensure the person is seated safely if jerks are frequent.

After a First Seizure

If someone has a first-ever seizure, they must be seen by a doctor — even if they recover quickly and feel well. A first seizure must be investigated to determine the cause. Call 999 if they don't recover quickly, or take them to A&E or arrange a same-day GP appointment.

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