How to Help Someone Having a Seizure | The Survival Doctor

A patient gets fitted for an EEG test, which can be used to figure out the cause of seizures.

by James Hubbard, MD, MPH

When I was a teenager, I experienced my first seizure. Actually, I didn’t have one. I didn’t even see it, but it affected me.

I was at a lake outing. I noticed some people gathered around next to a car. Everyone was looking down at the same spot. I heard someone nearby say a woman just had a seizure. I didn’t exactly know what one was, but I knew it was bad. About the worst thing that could happen to someone, I surmised, outside of dying. And all I could think is, I’m glad I wasn’t there when it happened. I wouldn’t have had a clue what to do.

Later I found out, the thing you do is make sure the person doesn’t swallow their tongue. It wasn’t until I was in medical school that I found out it’s impossible to swallow your tongue. And thereby goes another myth.

Seizures Without the Jerking

There are different types of seizures. Sometimes people don’t jerk and shake. They may just stare straight ahead or start rapid blinking or chewing and seem unaware of their surroundings. In those cases, as in the grand mal seizures with the jerking and shaking, if you remember nothing else, remember the medical axiom “do no harm.”

Other than keeping them from harming themselves or others, and keeping them on their side, the best thing to do is leave them alone and let the seizure run its course.

One reason I became a doctor is so I would know what to do in situations like that. Since then, I’ve seen my share of seizures. They’re still scary. But now I know what to do. And you should too. Because most of the time, it’s pretty simple, if you just follow a few rules of seizure first-aid:

  1. Never try to stop the seizure. Unless you have proper medicine and a way to give it, you can’t. Don’t hold the person or try to keep them from jerking or shaking. You’re only going to risk harming yourself or the person.
  2. Move away any objects that could be harmful. Remove neckties and glasses. If something is propping the person up, gently help the person to the ground. If they’re in an area of danger, such as the edge of a roof or near machinery, ease them away to a safer area. Otherwise let the seizure run its course, which can take a few seconds or a few minutes.
  3. Never put anything in the person’s mouth. There’s absolutely no danger the person is going to swallow the tongue. It’s impossible. Never happens. And, if you were to try to grab it, there’s a really good chance you’d get bitten.
  4. Try to position the person so the airway is open, especially after the seizure. The tongue can’t be swallowed, but the person is close to unconscious, and with gravity, the back of the tongue can block the airway. You could try to pull on it now, but that’s hard to do, and you’d have to hang on and not let go. And you’re still at risk to get bitten.

    Instead, turn the person on their side, and the tongue should move enough out of the way. To keep the person in that position, hold the back in place, or prop with cushions or other soft objects. If you can easily bend the person’s knees and place the top one slightly in front of the back one, this helps hold the position also.
  5. Don’t try to wake the person up. You’ll usually only agitate them. They will gradually wake up, usually disoriented. They usually don’t want to be touched. Talk to them calmly. Tell them they’ve had a seizure, but reassure them everything’s OK.
  6. Never give the person anything to eat or drink until they’re fully alert, awake, and sitting up.
  7. The Survival Doctor's Guides to Burns and Wounds, by @James HubbardNever leave the person until they’re fully awake or until someone else you trust has taken over their care.
If you’re in a situation where 911 is available and you haven’t called it already, be sure to do so if:
  • The seizure lasts more than five minutes.
  • Another seizure follows the first one.
  • The person’s having trouble breathing.
  • The person’s not gradually waking up after the seizure, or there seems to be an injury.

Many times, though, this is not person’s first seizure. They know what to do. They’re embarrassed as much as anything, and very sore. Have some empathy. They’re no different than anyone else with a chronic disease. Except, unlike high blood pressure, a seizure is visible—and scary to the people who see it and, especially, to the person having one.

What has been your experience? Have you ever had one? Seen one? How did you feel? Did you know what to do?

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Photo: Flickr/JanneM