Approximately one in 10 people may have a seizure at some point in their lives, according to the Centers for Disease Control and Prevention (CDC)—and with those statistics, you may one day be around someone experiencing a seizure. But while you might want to jump to action if you see someone convulsing, it's important to understand when you should—and shouldn't—intervene.
"The vast majority of seizures last a minute or two and then end on their own," Vikram Rao, MD, PhD, an associate professor of neurology at the University of California, San Francisco, tells Health. "The real job is to make sure the patient is as safe as possible while they're experiencing the seizure."
Here, we've compiled information from experts and guidance from the CDC on what you can do to take care of someone during a seizure—along with information on what you should really avoid or leave to a trained medical professional.
What should you do when someone has a seizure?
If someone has a seizure, the best thing you can do is stay calm and remind yourself that it will probably end soon. You can't stop a seizure, no matter what kind it is, and the less you interfere with someone who is having one, the better.
Here's a breakdown of what to do when someone has a seizure, according to guidance from the CDC:
- Don't leave. Stay with the person throughout their seizure and until you're sure they're fully awake.
- Bring them to a safe place. Once the seizure has ended, escort them to a calm, safe environment to help them recover.
- Explain what happened. Use very simple terms to tell the person what they experienced during the seizure. That can help fill in any gaps in their memory and give them important information to share with a doctor. Comfort them and remain calm.
- Help them get home. A person who just had a seizure may feel out of it and need some help getting home. Consider calling them a cab, or getting in touch with a family member who can provide support.
Most seizures don't require emergency medical assistance, per the CDC. And according to Northwestern Medicine, 19 out of 20 seizures come to an end in just two to three minutes. But if a seizure lasts more than five minutes, that's a sign to call 9-1-1.
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What should you do when someone has a tonic-clonic (grand mal) seizure?
While the above guidelines can help you handle any type of seizure, there are some additional things you can do when someone has a tonic-clonic seizure (formerly known as a grand mal seizure). This is the kind of seizure where someone may cry out, drop to the ground, shake, and lose consciousness, though exact symptoms can vary from person to person.
Here what you should do when someone has a tonic-clonic seizure, per the CDC:
- Gently move them to a space where they won't hit their head or cut themselves.
- Ease them to the floor.
- Remove any hard or sharp objects from the area.
- Turn them to their side to help them breathe more easily.
- Place something soft and flat under their head (a folded sweatshirt or jacket can do the trick).
- If they wear glasses, gently remove them.
- Loosen their scarf, tie, or anything else that might make it harder for them to breathe.
As with any type of seizure, keep an eye on the clock—if a tonic-clonic seizure lasts for more than five minutes, get emergency medical attention ASAP.
When does a seizure become a medical emergency?
The duration of a seizure can help you tell if it's becoming a medical emergency (five minutes or longer is a red flag). But there are also some other factors that turn a seizure into a dangerous situation. The CDC advises getting help for a person having a seizure if:
- It's their first seizure. They may wear a medical bracelet if they have a condition that causes seizures, so check their wrists for clues.
- They have back-to-back seizures, especially if they don't regain consciousness in between ("seizure clusters," or "status epilepticus," increase a person's risk of death).
- They're in water. (This can be a life-threatening situation—check out the Epilepsy Foundation's other recommendations for handling seizures in water.)
- They're struggling to breathe or wake up after the seizure.
- They're hurt or injured.
- They're pregnant, or have a health condition like diabetes or heart disease. (Again, you may not know this until the person is alert and able to tell you).
Even though most seizures are not a medical emergency, there's nothing wrong with reaching out for help—just in case. Never hesitate to call 9-1-1 if you're concerned about someone's well-being during a seizure (or any other situation).
RELATED: 6 Things That Can Trigger a Seizure Even If You Don't Have Epilepsy
What should you avoid doing when someone has a seizure?
In addition to what you can (and should) do when you experience someone having a seizure, there are also things that you should absolutely not do. According to the CDC, you should avoid doing the following things if someone around you is having a seizure:
- Don't hold the person down. If the person is convulsing at all, you should not try to restrain their movements in anyway.
- Don't put anything in their mouth. Contrary to past beliefs, you should not attempt to put an object (a wooden spoon, your finger, etc.) in a person's mouth during a seizure. "We've been taught that a person having a seizure is going to swallow their tongue, but nobody swallows their tongue during as seizure. That's a myth," says Dr. Rao. "We advice never putting anything in somebody's mouth." Doing so can injure a person's teeth or jaw, the CDC says.
- Don't try to give them mouth-to-mouth breaths. People will usually start breathing on their own again after a seizure so CPR is not necessary.
- Don't offer the person food or water. Make sure a person is fully awake and alert before you offer them anything to drink or eat following a seizure.
Additionally, you should also try not to panic when someone has a seizure. Keep in mind that the period after a tonic-clonic seizure can be nearly as intense for someone as the seizure itself. The person might feel confused, scared, irritable, nauseous, or embarrassed, and it's important that those around them stay calm.
For some, "it's almost like if you kidnapped them and then they woke up from it," Derek Chong, MD, MSc, vice chair of neurology at Lenox Hill Hospital in New York City, tells Health. "They're often fighting because they have no idea what's happened and they don't recognize anyone; and so they can be very agitated. There are EMTs who have been punched and bitten and stuff like that, because [the patient] feels like their life is being threatened."
Don't address a person who's just had a serious seizure with a worried, urgent tone—instead, give them a chance to slowly regain consciousness, then speak to them in a soft, reassuring voice. Explain what happened and let them know that you will stay with them until they are able to get home safely.
Everyone should understand the basics of what to do during a seizure, but if you have a family member or loved one who has epilepsy or another neurological disorder that causes seizures, you might want to take your expertise to the next level by getting Seizure First Aid Certified. Among other things, you'll learn how to recognize the signs of a seizure, and get a deeper understanding of when medical assistance is necessary.
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