What To Do

What To Do - First Aid

First Aid for Convulsive Seizures

When providing seizure first aid for generalized tonic clonic (grand mal) seizures, these are the key things to remember:

  • Keep calm and reassure other people who may be nearby.
  • Don’t hold the person down or try to stop his movements.
  • Time the seizure with your watch.
  • Clear the area around the person of anything hard or sharp.
  • Loosen ties or anything around the neck that may make breathing difficult.
  • Put something flat and soft, like a folded jacket, under the head.
  • Turn him or her gently onto one side. This will help keep the airway clear.
  • Do not try to force the mouth open with any hard implement or with fingers. A person having a seizure CANNOT swallow his tongue. Efforts to hold the tongue down can injure teeth or jaw.
  • Don’t attempt artificial respiration except in the unlikely event that a person does not start breathing again after the seizure has stopped.
  • Stay with the person until the seizure ends naturally.
  • Be friendly and reassuring as consciousness returns.
  • Offer to call a taxi, friend or relative to help the person get home if he seems confused or unable to get home by himself.

First Aid for Non-Convulsive Seizures

You don’t have to do anything if a person has brief periods of staring or shaking of the limbs. If someone has the kind of seizure that produces a dazed state and automatic behavior, the best thing to do is:

  • Watch the person carefully and explain to others what is happening. Often people who don’t recognize this kind of behavior as a seizure think that the dazed person is drunk or on drugs.
  • Speak quietly and calmly in a friendly way.
  • Guide the person gently away from any danger, such as a steep flight of steps, a busy highway, or a hot stove. Don’t grab hold, however, unless some immediate danger threatens. People having this kind of seizure are on “automatic pilot” so far as their movements are concerned. Instinct may make them struggle or lash out at the person who is trying to hold them.
  • Stay with the person until full consciousness returns, and offer help in returning home.

When to Call for an Ambulance

No Need to Call an Ambulance if —

  • medical I.D. jewelry or card says “epilepsy,” and
  • the seizure ends in under five minutes, and
  • consciousness returns without further incident, and
  • there are no signs of injury, physical distress, or pregnancy.

An Ambulance Should Be Called if —

  • the seizure has happened in water.
  • there’s no medical I.D., and no way of knowing whether the seizure is caused by epilepsy.
  • the person is pregnant, injured, or diabetic.
  • the seizure continues for more than five minutes.
  • a second seizure starts shortly after the first has ended.
  • consciousness does not start to return after the shaking has stopped.

If the ambulance arrives after consciousness has returned, the person should be asked whether the seizure was associated with epilepsy and whether emergency room care is wanted.

Is an Emergency Room Visit Needed?

When these conditions exist, immediate medical attention is necessary:

  • Diabetes
  • Brain infections
  • Heat exhaustion
  • Pregnancy
  • Poisoning
  • Hypoglycemia
  • High fever
  • Head injury

An un-complicated generalized tonic clonic (grand mal) seizure in someone who has epilepsy is not a medical emergency, even though it looks like one. It stops naturally after a few minutes without ill effects. The average person is able to continue about his business after a rest period, and may need only limited assistance or no assistance at all, in getting home. In other circumstances, an ambulance should be called.

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