Witnessing someone having a seizure can be overwhelming, but learning first aid for seizures and knowing how to respond safely can make a crucial difference. This guide provides practical first aid steps for two situations you may encounter: seizures in people with epilepsy and febrile convulsions in young children.
Each situation requires specific considerations, though the fundamental principles of keeping someone safe and knowing when to seek help remain consistent. Whether you’re dealing with an expected seizure in someone with known epilepsy or an unexpected convulsion in a febrile child, your calm and informed response is vital.
Febrile Convulsions in Children
Febrile convulsions are a type of seizure that may occur in children aged six months to six years when they have a high fever, typically above 38°C. Understanding first aid for seizures in this context is particularly important as these convulsive episodes affect approximately 3-4% of children and are usually brief, lasting less than five minutes.
When a febrile seizure occurs, the child’s body stiffens and they may experience jerking movements throughout their body. The child will lose consciousness and may appear blue around the lips due to temporary breathing difficulties. While frightening to witness, most febrile convulsions are harmless and do not indicate epilepsy.
Epilepsy and Epileptic Seizures in Adults and Children
Epileptic seizures result from sudden, abnormal electrical activity in the brain and can affect people of all ages. People with epilepsy may experience different types of seizures, and understanding these variations helps provide appropriate first aid for seizures.
Tonic-clonic seizures (formerly called grand mal) are the most recognisable type. During a tonic-clonic seizure, the person loses consciousness as their body stiffens (tonic phase) before experiencing rhythmic jerking movements (clonic phase). The person may bite their tongue, lose bladder control, or have difficulty breathing during the episode.
Focal seizures affect only part of the brain and may cause unusual sensations, movements, or behaviours without complete loss of consciousness. The person may appear confused or unresponsive but can often hear and understand what’s happening around them.
Absence seizures involve brief episodes where the person appears to stare blankly and becomes temporarily unresponsive. These are most common in children and may be mistaken for daydreaming.
Seizure First Aid
When someone is experiencing a seizure, follow this systematic approach to ensure their safety and your own. Effective first aid for seizures can prevent serious injuries and complications:
During the seizure:
- Stay calm and note the time the seizure started. Timing how long the seizure lasts is crucial information for medical professionals.
- Keep the person safe by guiding them away from danger. If they’re standing, help them to the ground gently. Clear the area of sharp objects, furniture, or anything that may cause injury.
- Protect their head by placing something soft underneath, such as a folded jacket or cushion. Never restrain their movements or try to stop the jerking.
- Do not put anything in the person’s mouth. Contrary to common myths, people cannot swallow their tongue during a seizure, and objects in the mouth may cause choking or dental injuries.
- Stay with the person throughout the seizure. Observe their breathing and the type of movements they’re experiencing to report to medical professionals later.
- Speak calmly and reassuringly, even if they appear unconscious. Your voice can provide comfort during this frightening experience.
After the seizure:
- Once the jerking stops, check if the person is breathing normally. If they’re unconscious but breathing, place them onto their side in the recovery position to keep their airway clear.
- Remain alert for any breathing difficulties or signs that they’re not regaining consciousness as expected.
- Provide reassurance as they wake up. The person may be confused, tired, or embarrassed. Explain what happened calmly and offer to help them contact someone or get medical attention.
- Check for any injuries that may have occurred during the seizure. Even minor head injuries should be assessed by medical professionals.
- Help the person sit or lie down comfortably until they feel ready to move. Recovery time varies, but most people need several minutes to feel normal again.
Special Situations: When to Call an Ambulance
Certain circumstances require immediate emergency action or modified approaches when providing first aid for seizures:
Call an ambulance immediately when:
- The seizure lasts more than 5 minutes
- The person has repeated seizures without regaining consciousness between episodes
- The seizure happens in water (drowning risk)
- The person is injured during the seizure
- The person has difficulty breathing after the seizure
- This is their first seizure or they’re not known to have epilepsy
- The person is pregnant
- The seizure is different from their usual pattern
Seizures in water pose serious drowning risks. If a seizure occurs while swimming, immediately support the person’s head above water and guide them to shallow water or poolside. Call an ambulance and continue standard seizure first aid once they’re safely out of the water.
First seizures in people without known epilepsy always require medical evaluation. Even if the seizure appears typical and the person recovers completely, they should be taken to the emergency department or see a doctor promptly to investigate the underlying cause.
FAQs
What is the Most Dangerous Type of Seizure?
Tonic-clonic seizures (formerly called grand mal seizures) are generally considered the most dangerous seizure type due to their potential for causing injury from falls, breathing difficulties during the episode, and the risk of developing into status epilepticus.
Is First Aid For Seizures the Same No Matter What Type?
The core safety principles remain consistent: protect from injury, don’t restrain movements, don’t put anything in their mouth, time the episode, and stay with the person. However, febrile convulsions in children may require additional steps like removing excess clothing to reduce fever, while seizures in people with known epilepsy might have specific management plans.
Do I Need First Aid Training to Help Someone Experiencing a Seizure?
While formal first aid training provides valuable confidence and comprehensive knowledge, you don’t need certification to help someone having a seizure. However, accredited first aid training teaches you to recognise various medical emergencies, provides hands-on practice, and helps you respond more effectively under pressure.
