You’re in the grocery store and suddenly you hear a commotion. Another shopper is on the floor—convulsing. You’re terrified. What should you do?
Sadly, these kinds of difficult situations happen frequently.
In fact, as many as 5.1 million Americans have been diagnosed with epilepsy or a seizure disorder. Epilepsy is a neurological disorder in which patients suffer from recurrent seizures. This illness has been on the rise for years and according to the Epilepsy Foundation, 1 in 26 individuals will develop epilepsy at some time in their life.
So what do you do if you’re out and run into a situation like this where someone is having a seizure? Beyond calling 9-1-1, knowing what to do—and what not to do—when someone is having a seizure could mean the difference between safely allowing the seizure to pass and causing an injury.
How do you know if someone is having a seizure?
A seizure is uncontrolled brain activity, which can lead to uncontrolled movements and behavior. When someone is experiencing a generalized chronic seizure, they may:
- Fall or collapse
- Become unconscious
- Convulse or shake
- Stiffen and relax their muscles
- Scream, grunt, or snort
- Clench their teeth
- Flail, twitch, or jerk their arms and legs
- Drool
- Become confused afterward
How long do seizures last?
The typical duration of a seizure lasts between one to three minutes. If it lasts longer than five minutes, you should call 9-1-1.
“Longer seizures can be damaging to the brain,” says Timothy Lucas II, MD, PhD, neurosurgeon at Penn Medicine. “This is because seizures can use up the brain’s supply of oxygen and glucose, leading to a secondary brain injury.”
Four other signs you need to call 911 when a seizure occurs
- If the person has trouble breathing afterward or does not awaken after the convulsing has stopped
- If the person has another seizure shortly after the first
- If the person becomes injured or starts getting aggressive
- If the person has a known health condition, such as diabetes or heart disease, or is pregnant
When Someone Is Having A Seizure
Now that you know how to spot a seizure, it’s very important to know how to best help.
Step 1: Don’t put anything in the person's mouth.
“There’s an old wives’ tale that when someone is having a seizure, you should put something in the person’s mouth,” says Kathryn Davis, MD, MTR, neurologist and medical director of the Epilepsy Monitoring Unit at the Penn Epilepsy Center. “That is something you absolutely should not do.”
Here’s why: The person can clamp down on the object, bite off a piece, and choke on it. If you put your hand in their mouth, they could bite down on it.
The object will not prevent the person from choking on their tongue. “I’ve never heard of someone choking on their tongue,” Dr. Davis adds.
Step 2: Move the person to a safe place.
“This doesn’t always mean hoisting the person around,” cautions Dr. Lucas. “It means getting them out of the way of any imminent threat.”
| The Location |
The Threat |
What To Do |
| Stairs |
A fracture or head injury from falling down the stairs |
Take the person to the platform of the last step and lay them on their side. |
| Bathtub |
Drowning |
If the person is in the tub, make sure the head is above water to get air. |
| Pool/Beach |
Drowning. "The seizure may only last a minute, but a minute under water can be dangerous," says Dr. Lucas. |
Make sure the person is able to get air during the seizure and for a few minutes afterward until consciousness returns. |
| Kitchen |
Stabbing injury |
"If they are handling a sharp knife, take it from them, and remove any nearby," says Dr. Lucas. |
Step 3: Turn the person onto her side
The person can produce lots of saliva, which they could choke on. Also, turning them can help keep their airway clear, since the diaphragm can't contract.
When someone is having a seizure, Dr. Lucas says DO NOT:
- try to hold the person down: This can cause injury and won't make the seizure stop.
- leave when the seizure is over: Wait a few minutes to make sure the person can breathe normally and returns to a normal state of awareness. If they still can't breathe or still seem disoriented, call 9-1-1.
- offer them anything until they are alert: Avoid choking by waiting to offer water, pills, or food.
Stay up-to-date on the latest treatment options for your seizure disorder.