How to treat a seizure: What to do if you see someone seizing

by James Hubbard, M.D., M.P.H.

When I read Senator Ted Kennedy had a seizure at a public dinner on inauguration day, it got me thinking, does the average person know what to do if someone’s having a seizure?

As a teenager, I witnessed a seizure while I was at a park, and it scared me to death. (I scared easily as a teen.)  The man jerked and flailed uncontrollably in an unconscious state surrounded by onlookers, and no one knew what to do.

People yelled, “Hold him down so he won’t hurt himself!”  “Put something in his mouth so he won’t swallow his tongue!”  “Call an ambulance!”  After, what seemed like an eternity, he just lay limp and moaned.  Later I saw his friends help him up and they drove away.

Now that I am a doctor (said in hushed, hallowed tone) I know what I should have done.

Just what I did, nothing.  Anything I would have tried would only have made the situation worse.

Here are some tips on what to do if you see someone having a seizure.

  1. Give the person room. Help them gently to the floor and remove any potential dangerous objects.  Then just let the seizure play out.  Don’t hold them down or put anything in their mouth.  You’ll only harm yourself or the person.  No one has ever literally swallowed their tongue.
  2. When the jerking stops, place the person on their side. This will help keep the airway open and let any fluids, such as vomitus, drain out.  If the person fights you, just try turning only the head to the side.  Still fighting?  Just make sure they’re breathing without difficulty and try turning the head if you notice vomiting.
  3. Look for a bracelet, necklace, tag or friend for information about a past seizure history.
  4. Leave the person alone otherwise.They’ll be groggy, confused and annoyed as they wake up.
  5. Call an ambulance if the seizure lasts more than three to five minutes, they’re not gradually waking up or are having trouble breathing, or you’re unsure of the seizure history.

You really can’t go wrong as long as you don’t panic, use common sense and remember, “Do no harm.”
Have you ever had or witnessed a seizure?

To get things started I asked real life, in-the-field paramedic, Beth Nelson,  to comment on my post.  Here’s what she said:

Very good, for a doctor ; )

I’d put Call 911 at #1 (maybe I’m bias though).  Since the context is that this person is a stranger, not one with a known epilepsy, it’d be safer to just call 911.  If they wake up and tell the medics that they have a hx of epilepsy and have someone with them that can drive them home/watch them for a while, the medics will let them go about their business.  But if it’s trauma, diabetic, alcohol, drugs, etc etc, they may have just saved a life simply by calling 911 so we can try to fix the underlying…….

but, like I said, maybe i’m just bias  : )

Excellent subject to tackle though, can’t tell you how many high schools we’ve been to where we had a sz patient that I had to take a tongue blade / bite block / etc. out.  Some first aid kits still have the old bite blocks with instructions to do the old-school shove it in their mouth thing.

Thanks to Beth who is, I am proud to say, my daughter.

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9 Responses to “How to treat a seizure: What to do if you see someone seizing”

  1. Sagan Says:

    Thanks for this information. There was a guy in my high school who was epileptic and had seizures during every math test- I didn’t have that class with him but I would have had no idea what to do if I’d been there. It’s good to be prepared.

    Also that’s so nice that you and your daughter work in the same field!

  2. James Hubbard, M.D., M.P.H. Says:

    Thanks Sagan,

    Seizures can be scary for everyone including the one having them. Most probably won’t see one but just in case, maybe they will remember this post.

  3. Steve Parker, M.D. Says:

    Great info and very timely, Dr. Hubbard. I agree with Beth about calling 911, especially if it’s a stranger on the street with no medical history details available.


  4. Dr. Hubbard Says:

    Dr. Parker,

    Thanks for making that important point clear.

    I am outvoted. Always call 911 first.

  5. Dr. J Says:

    Nice article!

    I’ve had the surprise pleasure of being there for a seizure on the street! The only thing I might add is I try to protect the person’s head so they don’t hit it against the ground. I have cradled their head on my lap, and made sure their airway was patent, then just waited it out. Of course, we know that each case is different.

    Dr. Js last blog post..Nibbles: More peanut products recalled, Japan says cloned meat OK, and how networks fuel inaugural coverage

  6. James Hubbard, M.D., M.P.H. Says:

    Good point Dr. J.

  7. Disease Specific Resources | VP-Medical News Says:

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  8. ELynn Says:

    When I was a senior in high school, I was in a math class with a girl who had seizures. I have never seen a person have a seizure before until one day in class at school, she had a seizure. She had the grand mal seizure. I remember the teacher was trying to call her attention but the girl kept zoneing out. Then she went into a full blown seizure attack during class. It was so scary to see someone having a seizure. I almost started to cry because it scared me so much. My teacher had to time the seizure. The girl was shaking in her chair and her eyes were rolling back into her head, then she started to come out of it. Then I remember she started peeing in her pants after she came out of the seizure. I looked over and I saw her peeing because it went all over the floor. It was upsetting to see. I have heard that sometimes when a person has a seizure they sometimes lose control of their bladder or bowels and thats what happened to that girl in class. She had lost control of her bladder after the seizure. I have never experienced a seizure so I dont know what it feels like to have one, but I know what it feels like to see someone having one. Its scary, but you just have to remain calm and help the person and stay with them until they are okay or help arrives.
    ELynn recently posted..Quiz of the Month: Valentine’s Day, Doctor Style

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