Seizure first aids start with staying calm, which sounds ridiculously simple until you’re actually watching someone shake uncontrollably on the ground. About 1 in 10 people will have a seizure in their lifetime, which means someday you’ll probably need to help someone. The movies get seizure first aids spectacularly wrong. Nobody needs a wallet between their teeth (please never do this). Nobody’s going to swallow their tongue (anatomically impossible). And restraining someone having a seizure helps absolutely no one.
What actually works is boring, simple, and saves lives. Most seizures last just a few minutes and stop on their own. Your job isn’t to stop the seizure. It’s to keep the person safe until it ends. Let’s talk about the real seizure first aids that matter, the technology making epilepsy management easier, and why stigma around seizures needs to die already.
What Actually Happens During a Seizure
Seizures are episodes where someone may fall down if they lose muscle tone or consciousness, shake or jerk, twitch in body or eyelids, or become unaware of what’s around them. Not all seizures look the same. Some are non-convulsive seizures where the person shows signs of confusion, unresponsiveness, or inappropriate behavior, appearing to be intoxicated.
The tonic-clonic seizure, formerly called grand mal, is what most people picture. The tonic phase comes first, where muscles clench and become rigid. The person loses consciousness, falls, and their body stiffens. Then comes the clonic phase with muscle convulsions. They may appear to stop breathing as their chest muscles tighten, but muscles will relax as this phase ends and breathing should resume normally.
Watching this terrifies people into making mistakes. They try to hold the person still (doesn’t work, can cause injury). They put things in the person’s mouth (breaks teeth, causes choking). They crowd around (overwhelming when person wakes up). Understanding what’s happening helps you respond properly instead of panicking.
The Actual Seizure First Aids Steps
- Keep yourself and others calm. Stay with the person. Remove anything near them that can cause injury. Check to see if they are wearing a medical bracelet for information. These are your starting points for proper seizure first aids.
- Ease them to the ground if they appear to be falling. Turn them gently onto one side with their mouth pointing to the ground. This will keep their airway clear. The side position prevents choking if they vomit and keeps their airway open. Help them breathe easier by loosening any clothing around their neck.
- Clear the space around them to prevent injury. Put something soft and flat under their head like a jacket. Take off their eyeglasses. Move furniture, sharp objects, anything they could hit during convulsions. Don’t try to move the person unless they’re in immediate danger like near traffic or water.
- Time the seizure to track if it lasts more than 5 minutes. Pull out your phone, note when the seizure started. Most seizures are not a medical emergency, but if the seizure lasts for more than 5 minutes, call 911. Five minutes is the critical threshold. Anything longer requires emergency medical attention.
- Talk calmly and reassuringly to the person during and after the seizure. It will help as they recover . They might be unconscious during the seizure, but as they come out of it, your calm voice provides orientation and comfort.
What NOT to Do: Debunking Dangerous Myths
Seizure first aids are evolving alongside technology. You may have heard that people with a seizure could swallow their tongue. This is not true, and holding the tongue can injure both yourself and the person having the seizure. It is a myth that someone can swallow their tongue during a seizure. Placing an object in their mouth could cause them to choke or break their teeth.
Don’t give mouth-to-mouth breaths during the seizure. People usually start breathing again on their own after a seizure. Do not administer CPR during the seizure as muscles will relax as this phase ends and breathing should resume normally. Only provide CPR if they don’t start breathing after the seizure ends.
Do not restrain them. Don’t try to hold a person down or try to stop the person’s movements. Restraining someone during a seizure can cause muscle tears, fractures, or dislocations. The seizure will run its course regardless of what you do.
Don’t offer water or food until they are fully alert. This is not necessary and could cause them to choke. Don’t give them anything to eat or drink, and don’t give any pills or liquid medicines by mouth until they are completely awake and alert.
When Seizure First Aids Becomes a 911 Call
Seek immediate medical attention if the seizure lasts longer than 5 minutes, they have another seizure soon after the first one, they have trouble breathing or waking up after the seizure, they are injured during the seizure, the seizure happens in water, they’ve never had a seizure before, or they have diabetes and lose consciousness.
One seizure occurring right after another without the person regaining consciousness or coming to between seizures requires emergency help. This condition called status epilepticus is life-threatening.
First-time seizures always warrant medical evaluation. Even if the person seems fine after, they need to see a doctor to determine the cause. Seizures can result from epilepsy, but also from strokes, brain tumors, infections, diabetic emergencies, or head injuries. The underlying cause needs investigation.
After the Seizure: The Recovery Phase
Stay with the person until the seizure ends. Be friendly and reassuring, and offer help if needed. Be sensitive and supportive. People may feel embarrassed or confused about what happened. Reassure the person that they are safe.
Give the person some space and clear any crowd that may have gathered. For the person having a seizure, a crowd can be embarrassing and overwhelming. People love to gawk at medical emergencies, but it’s awful for the person experiencing it. Politely disperse onlookers.
Once they are alert and able to communicate, tell them what happened in very simple terms. Offer to stay with the person until they are ready to go back to normal activity or call someone to stay with them. Don’t rush them. The post-seizure period called the postictal phase can involve confusion, exhaustion, and disorientation.
Technology That Actually Helps
Seizure detection wearables have evolved dramatically. Embrace2 is the world’s first FDA-cleared wrist-worn wearable in epilepsy that detects possible convulsive seizures and instantly alerts caregivers. SmartWatch detects repetitive shaking motion and automatically sends text and phone call alerts to designated recipients including GPS location and duration of the event.
EpiWatch received FDA clearance for its seizure detection platform that runs on the Apple Watch, designed to continuously monitor for tonic-clonic seizures. The platform goes beyond detection, offering medication reminders, trigger tracking, mental health screening, and seizure logging.
These devices have limitations worth understanding. Detection of convulsive or motor seizures is relatively easier than other seizure types, and studies are beginning to address these other more difficult semiologies but only with modest success to date. Wearables work best for tonic-clonic seizures with significant movement. They struggle with absence seizures or focal seizures without obvious physical manifestations.
While these devices offer advantages such as recognizing specific seizure activities characterized by significant movements, they may have limitations in detecting all seizure types and can be costly for specific individuals. The technology isn’t perfect and shouldn’t replace medical care, but it provides valuable safety monitoring and data collection.
Stigma: The Invisible Barrier to Care and Seizure First Aids
Here’s an uncomfortable truth: many people with epilepsy hide their condition because of stigma. They don’t tell employers, friends, sometimes even partners. This silence can be deadly. If no one knows you have seizures, no one knows to provide proper seizure first aids when you need it.
Free, online on-demand training is available through the Epilepsy Foundation Earthly Threads for anyone who wants to learn proper seizure response. Schools, workplaces, community groups should make this training standard. The more people who know seizure first aids, the safer everyone becomes.
People assume epilepsy means you can’t live independently, work, drive, or have relationships. None of this is necessarily true. Most people with epilepsy manage their condition well with medication. They work, drive, raise families, and live full lives. The biggest barrier isn’t the seizures. It’s other people’s fear and misconceptions.
Access to Treatment: The Global Gap
Epilepsy affects about 50 million people worldwide. WHO estimates that up to 70% of people living with epilepsy could live seizure-free if properly diagnosed and treated. Think about that. Seven out of ten people with epilepsy could be seizure-free with proper care. Yet millions lack access to basic anti-seizure medication.
Cost creates barriers even in wealthy regions. Newer anti-seizure medications can be expensive. Seizure detection wearables cost hundreds of dollars plus subscription fees. Brain scans and specialist consultations add up quickly. For people without insurance or in areas with limited healthcare infrastructure, epilepsy management becomes impossible despite effective treatments existing.
Community education matters enormously. When families and communities understand epilepsy and proper seizure first aids, outcomes improve. When seizures are seen as medical events requiring calm response rather than supernatural events requiring fear, people get help instead of hiding.
A Clearer Way Forward
International Epilepsy Day reminds us that awareness is not just about facts. It’s about behavior. It’s about replacing panic with knowledge. Stigma with understanding. Silence with clarity.
Seizure first aids work best when they’re simple, shared, and practiced in everyday language. No drama. No fear. Just people looking out for people.
That’s how real safety spreads.
