Seizure: protect, do not restrain
During a seizure, make the surroundings safe, cushion the head, do not restrain the person and put nothing in their mouth. Time it. After the seizure check breathing: if the person does not respond but breathes normally, place them in the recovery position. Call the emergency number (112 in the EU) always with a first seizure, if it lasts longer than 5 minutes, with injuries, in water, in pregnancy or if the person does not come round. This text does not replace a first-aid course.
- During the seizure and until the person is clear again
Explained simply
During a seizure a person often suddenly falls, goes stiff and jerks their arms and legs. It looks frightening. But usually it stops on its own after a short time.
You cannot stop the seizure – but you can protect the person. Move hard things away, put something soft under the head and look at the clock. Do not hold the person down and do not put anything in their mouth. When the jerking has stopped, check breathing. If they breathe normally but do not respond, they go into the recovery position.
You call the emergency number (112 in the EU) with a first seizure, if it lasts longer than 5 minutes, if the person is injured, was in water or is pregnant – and always when you are unsure. This text does not replace a first-aid course.
How it works
In the brain, nerve cells normally work together in an orderly way. During a seizure many of them suddenly fire at once and uncontrollably. Then the muscles cramp, the body jerks and the person is usually not conscious.
After the seizure the brain is exhausted: many people are confused for a while, very tired or fall asleep. That is normal. There are many causes – epilepsy, fever in young children, low blood sugar, head injuries, heatstroke or poisoning.
What really matters
Protect rather than restrain: anyone who suppresses the jerking can injure themselves and the person. Nothing in the mouth – no bite block, no cloth, no fingers. That can injure teeth and fingers and block the airway.
Timing it matters more than it sounds: if a seizure lasts longer than 5 minutes, the person urgently needs the ambulance service. Afterwards, stay with them until they are fully clear again, calmly explain what happened and shield them from curious onlookers.
Safety and limits
Emergency number (112 in the EU, in Austria also 144): with a first seizure, after more than 5 minutes, with several seizures in a row, with injuries, in water, in pregnancy, with breathing problems afterwards or if the person does not wake up normally. If they are not breathing normally after the seizure: resuscitation as the dispatcher instructs.
Some people with epilepsy carry an emergency card. You only give emergency medication if this has been agreed with the person by their doctor and you have been instructed. This text names no medication.
How to practise it
You practise the recovery position after a seizure on a first-aid course. If someone in your family, class or workplace lives with epilepsy, ask what matters for that person during a seizure.
Young children can have seizures with fever. The procedure is the same: protect, do not restrain, time it. With a first febrile seizure always call the emergency number.
Step by step
- 1
Stay calm, time it
Look at the time when the seizure begins. Stay with the person.
- 2
Make the surroundings safe
Clear away hard and sharp objects and keep the person away from stairs, road or water as far as possible without restraining them.
- 3
Protect the head
Put something soft such as a jacket or blanket under the head. Remove glasses and loosen tight clothing at the neck if that is easy.
- 4
Do not restrain, nothing in the mouth
Do not suppress the jerking and do not push anything between the teeth.
- 5
Call if needed
Call the emergency number with a first seizure, after more than 5 minutes, with injuries, in water, in pregnancy or when unsure.
- 6
After the seizure: check breathing
When the jerking has stopped, check breathing. If the person does not respond but breathes normally: recovery position. If they are not breathing normally: resuscitation as the dispatcher instructs.
- 7
Look after them
Stay until the person is fully clear again, calmly explain what happened, shield them from onlookers and cover them. Give nothing to eat or drink until they can swallow safely again.
Common mistakes
- Holding the person down
- Putting something in their mouth
- Not timing the seizure
- Leaving the person alone after the seizure
- Not calling the emergency number with a first seizure
Quick view
Materials
Wool blanket / duvet
To cushion the head and cover the person
Keep away from candles, stoves and heaters.
Mobile phone
Clock to time the seizure
The battery drains quickly in cold and with continuous screen and GPS use.
Do not plan on it as your only means of navigation or emergency calls.
Suitable for
- Seizures with jerking of the whole body in adults and children
- People with known epilepsy and strangers
Not suitable for
- Lay people giving medication without medical arrangement
- Holding down or suppressing the jerking
Prerequisites
- Staying calm
- The surroundings can be made safe
Safety
- This text does not replace a first-aid course. First aid is learned through hands-on practice under instruction. In an emergency always call professional help – via the local emergency number (112 in the EU) – and follow the dispatcher's instructions.
How it works
During a seizure, nerve cells in the brain discharge uncontrollably. Often the person loses consciousness, falls, stiffens and jerks rhythmically; afterwards they are often confused and very tired for a while. Most seizures stop on their own after a short time. First aiders cannot stop a seizure – their job is to prevent injuries, observe the duration, keep the airway open after the seizure and call for help in time.
Advantages
- Simple, clear rules
- Prevents secondary injuries
Disadvantages
- Seizures often seem very frightening to helpers
- Causes cannot be clarified on the spot
Deep knowledge
Background
The ERC first-aid guidelines recommend, during seizures, protecting the person from injury, not restraining them, putting nothing in their mouth, calling the emergency number when needed and checking breathing and consciousness after the seizure. The 5-minute threshold for calling is taught on many first-aid courses and by epilepsy organisations.
Seizures have many possible causes – epilepsy, fever in children, low blood sugar, head injuries, heatstroke, poisoning or alcohol withdrawal. That is why a first seizure must always be investigated by a doctor.
Variants
- Known epilepsy
- Some people with epilepsy carry an emergency card with instructions on when an ambulance is needed. Follow these and tell the dispatcher. Emergency medication only if this has been agreed with the person by their doctor and you have been instructed.
- Febrile seizure in children
- Young children can have seizures with fever. The procedure is the same: protect, do not restrain, time it. With a first febrile seizure always call the emergency number; then have the child checked by a doctor.
Common mistakes
- Holding the person down
- Putting something in their mouth
- Not timing the seizure
- Leaving the person alone after the seizure
- Not calling the emergency number with a first seizure
Limits and risks
- Does not replace a first-aid course
- No medication or dosages
- Causes can only be clarified by a doctor
Material alternatives
Derived from material properties: a substitute must have all relevant properties. Observe the notes on the substitute.
- Wool blanket / duvet
- Sleeping pad, Dry leaves, grass or conifer boughs (Collect only where allowed; no protected plants. Check for ticks and insects.), Backpack, Dry spare clothing (Carry it in waterproof packaging – wet clothing barely insulates.), Insulated cool box (Keeps cold only for a limited time; without ice packs or ice it is not a fridge.), Sleeping bag (Do not store compressed long-term; do not pack away damp.), Newspaper and cardboard (Flammable – keep away from candles, stoves, heaters and embers.), Insulated cooking box (hay box, thermal cooker) (Never put open flame or embers inside – only the hot, closed pot.), Long-stemmed thatch (reed, grass, rushes) (Extremely flammable – no open fire and no sparks nearby.)
- Mobile phone
- Headlamp / flashlight, Battery lantern / LED light
Results come exclusively from structured entries. No improvised instructions are generated.
Sources
European Resuscitation Council – Resuscitation (journal) (2021): European Resuscitation Council Guidelines 2021: First Aid
First aid for seizures: protect, do not restrain, nothing in the mouth, check breathing afterwards
European Resuscitation Council – Resuscitation (journal) (2021): European Resuscitation Council Guidelines 2021: Basic Life Support
Checking breathing, recovery position, resuscitation
Deutsches Rotes Kreuz (DRK): Erste Hilfe – Informationen und Kurse
Seizure: emergency call with a first seizure and long duration