Seizure First AidFirst aid for epilepsy is basically very simple. It keeps the person safe until the seizure stops naturally by itself. It is important for the public to know how to respond to all seizures, including the most noticeable kind -- the generalized tonic clonic seizure, or convulsions. When providing seizure first aid for generalized tonic clonic (grand mal) seizures, these are the key things to remember:
First Aid for Non-Convulsive SeizuresYou don't have to do anything if a person has brief periods of staring or shaking of the limbs. If someone has the kind of seizure that produces a dazed state and automatic behavior, the best thing to do is:
First Aid in Special CircumstancesA Seizure in WaterIf a seizure occurs in water, the person should be supported in the water with the head tilted so his face and head stay above the surface. He or she should be removed from the water as quickly as possible with the head in this position. Once on dry land, he should be examined and, if he is not breathing, artificial respiration should be begun at once. Anyone who has a seizure in water should be taken to an emergency room for a careful medical checkup, even if he or she appears to be fully recovered afterwards. Heart or lung damage from ingestion of water is a possible hazard in such cases. A Seizure in an AirplaneIf the plane is not filled, and if the seat arms can be folded up, passengers to the left and/or right of the affected person may be reassigned to other seats, so that the person having the seizure can be helped to lie across two or more seats with head and body turned on one side. Once consciousness has fully returned, the person can be helped into a resting position in a single reclining seat. If there are no empty seats, the seat in which the person is sitting can be reclined, and, once the rigidity phase has passed, he can be turned gently while in the seat so that he is leaning towards one side. Pillows or blankets can be arranged so that the head doesn't hit unpadded areas of the plane. However, care should be taken that the angle at which the person is sitting is such that his airway stays clear and breathing is unobstructed. A Seizure on a BusEase the person across a double or triple seat. Turn him on his side, and follow the same steps as indicated above. If he wishes to do so, there is no reason why a person who has fully recovered from a seizure cannot stay on the bus until he arrives at his destination First Aid for Generalized Tonic Clonic (Grand Mal) Seizures During a generalized tonic-clonic seizure, the person suddenly falls to the ground and has a convulsive seizure. It is essential to protect him or her from injury. Cradle the head or place something soft under it, a towel or your hand, for example. Remove all dangerous objects. A bystander can do nothing to prevent or terminate an attack. At the end of the seizure, make sure the mouth is cleared of food and saliva by turning the person on his or her side to provide an open airway and allow fluids to drain. If the person assisting remains calm, the person having the seizure will be reassured when he or she regains consciousness. Breathing almost always resumes spontaneously after a convulsive seizure. Failure to resume breathing signals a complication of the seizure such as a blocked airway, heart attack or severe head or neck injury. In these unusual circumstances, CPR must start immediately. If repeated seizures occur, or if a single seizure lasts longer than five minutes, the person should be taken to a medical facility immediately. Prolonged or repeated seizures may suggest status epilepticus (nonstop seizures), which requires emergency medical treatment. When providing seizure first aid for generalized tonic clonic (grand mal) seizures, these are the key things to remember: Keep calm and reassure other people who may be nearby. Don't hold the person down or try to stop his movements. Time the seizure with your watch. Clear the area around the person of anything hard or sharp. Loosen ties or anything around the neck that may make breathing difficult. Put something flat and soft, like a folded jacket, under the head. Turn him or her gently onto one side. This will help keep the airway clear. Do not try to force the mouth open with any hard implement or with fingers. It is not true that a person having a seizure can swallow his tongue. Efforts to hold the tongue down can injure teeth or jaw.
Head Injury During a SeizureIf the person hits his or her head while falling, his or her post-seizure condition should be carefully monitored. Although sleepiness and confusion are natural consequences of a seizure, it should always be possible to rouse the person without difficulty. A person who fails to return to consciousness after a seizure needs further medical assessment. If head injury is a possibility, the person should be closely observed for the following signs:
If any of these signs are observed, or if the patient has a persistent headache after a rest period, unconsciousness with failure to respond, unequal pupil size or excessively dilated pupils, or weakness of the limbs, immediate medical attention is essential. Is an Emergency Room Visit Needed?An uncomplicated generalized tonic clonic (grand mal) seizure in someone who has epilepsy is not a medical emergency, even though it looks like one. It stops naturally after a few minutes without ill effects. The average person is able to continue about his business after a rest period, and may need only limited assistance, or no assistance at all, in getting home. In other circumstances, an ambulance should be called. No Need to Call an Ambulance
An Ambulance Should Be Called
If the ambulance arrives after consciousness has returned, the person should be asked whether the seizure was associated with epilepsy and whether emergency room care is wanted. |
A generalized tonic clonic seizure. Here the whole brain is affecting from the beginning. In (a) there is a cry and loss of consciousness, arms flex up then extend in (b) and remain rigid (the tonic phase) for a few seconds. A series of jerking movements take place (the clonic phase) as muscles contract and relax together. In (c) the jerking is slowing down and will eventually stop. In (d) the man has been placed on his side to aid breathing and to keep the airway clear.