If you’ve never seen someone have a seizure, your first instinct might be to panic. But freaking out is the last thing you should do.
During any seizure—whether the person has convulsions or just seems half-awake—it’s important to keep calm. In the person’s confusion, others could seem more threatening, says Jacqueline French, MD, professor of neurology at NYU Langone’s Comprehensive Epilepsy Center and chief scientific officer for the Epilepsy Foundation. “People that should look familiar look unfamiliar, and people who are unfamiliar could look threatening,” she says. You might think you’re just trying to help, but the person could lash out in confusion, hurting him or herself—and you.
Your best bet is to keep your voice calm, says Dr. French. “The tenor of your voice and calmness in your voice will transmit that everything will be OK,” she says.
Some people will fall down during seizures, so lowering them to the ground can keep them from getting hurt. Just don’t force it if it’s agitating the person. Grabbing or restraining could come off as a threat and hurt you both, says Dr. French. For instance, forcing someone not to convulse could lead to a dislocated shoulder. If guiding the person to lie down seems dangerous, just keep him or her away from threats like oncoming traffic.
Once you’ve lowered the person, turn the person on his or her side so saliva can get out. Lay a pillow or jacket under the person’s head, and get any sharp objects like glasses, pens, and folders out of the way.
During a seizure, some people will flex and unflex their mouth muscles. “The jaw can clamp down really, really hard,” says Dr. French. “People can break their teeth.” But putting something in their mouth to prevent it will just make matters worse, she says. The object might break, and they could choke on the broken pieces.
While you’re giving first aid, check if the person has a medical bracelet. Unless the person has a medical condition and doesn’t want to rush to the hospital regularly for seizures, call 911. A person’s first seizure is a particular red flag, because it could mean there’s an undiagnosed issue like an infection or tumor, says Dr. French. It could also be the sign of a magnesium deficiency. No matter what, call an ambulance if the seizure lasts more than three minutes.
Try to keep other people from gawking if you can. “If they wake up and see a crowd of people around them and all staring at them, it’s very embarrassing,” says Dr. French. No one can help how they act during a seizure, so don’t let the person feel ashamed.
Once the seizure is over, stay with the person. The confusion of a seizure will gradually go away within minutes to half an hour. “You may need to reorient them and tell them where they are,” says Dr. French. If the person is alone, ask if there’s any medication he or she should be taking, and whether you should call anyone. Just avoid using these two words around anyone going through a crisis.