From the Doctor's Desk: First Aid for a Seizure

December 1, 2011

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By Daniel Hoch, PhD, MD
Editor, AAN.com for Patients and Caregivers

The need to know basic first aid is one of those things we don't often think about until an emergency situation arises. Many people know how to clean and cover a simple cut or bruise and maybe even wrap an injured joint. But, specialized first aid is less widely taught and known.

For example, I'm often asked by my epilepsy patients' families how they should respond to their loved ones when they have a seizure.

While much of what I tell them is common sense—like keeping the person safe from self-injury—not every part of it is completely intuitive. For example, people do bite their tongues during a seizure, but there's nothing you can do about it, so don't try.

For that reason, I was pleased to read "Quick Tips: What to Do If Someone Has a Seizure" in a recent issue of Neurology Now®. Perhaps even more importantly, this article was written by a patient and her doctor.

In my work with online patient groups, I've often been struck by the disparity between the "official" guidelines or recommendations published by large advocacy organizations and the kinds of advice patients give to each other.

In our studies (summarized here), we found that the informal counsel of other patients was often more practical and useful. For this reason, I often encourage my patients to talk to each other and have occasionally collaborated with them to create advice for others.

I applaud Stacey Chillemi and my colleague, Dr. Orrin Devinsky, for their article in Neurology Now and encourage others to follow in their footsteps by sharing the practical wisdom they've gained through living with a neurologic disorder.

For more excellent information about seizures in general (albeit, not co-authored by patients and doctors) see our epilepsy content at AAN.Com for Patients or find other epilepsy-related resources at Neurology Now.

Quick Tips: What to Do If Someone Has a Seizure

  1. Stay calm.
  2. Call 911 if the person is having her first seizure or is pregnant.
  3. Try to time the seizure. Seizures usually do not last longer than 60 to 120 seconds. If the seizure lasts longer than 3 minutes, call 911.
  4. If the person is standing, prevent her from falling by holding her in a hug, or try to help her gently to the floor.
  5. Move away furniture or other objects that might injure the person during the seizure.
  6. If the person having a seizure is on the ground when you arrive, try to position her on her side so that any saliva or vomit can leak out of her mouth rather than be swallowed or go down the windpipe.
  7. Do not put anything, including your fingers, into the person's mouth while she is seizing. You could chip the person's tooth, or your finger could be bitten.
  8. Do not try to hold the person down because this can cause injury, such as a dislocated shoulder.

After the Seizure:

  1. Check the person for injuries.
  2. If you could not turn the person onto her side during the seizure, do so when the seizure has ended and the person is calm.
  3. If the person is having trouble breathing, use your finger to gently clear her mouth of any saliva or vomit. If this does not work, call for emergency help.
  4. Loosen tight clothing around the person's neck and waist.
  5. Provide a safe area where the person can rest.
  6. Do not give the person anything to eat or drink until she is fully conscious and aware of her surroundings.
  7. Stay with the person until she is awake and any confusion wears off. Most people feel sleepy or confused after a seizure.