First Aid

First aid for seizures is quite simple, and can help prevent a child from being harmed during a seizure. First aid will depend on the individual child's epilepsy and the type of seizure they are having. Some general guidance is given below, but most of all it is important to keep calm and know where to find help.

Schools can agree an Individual Healthcare Plan with the child and their parents or carers. This will explain the types of seizures the child is likely to have, and what to do when the child has a seizure. It should also describe what represents a medical emergency for the child and how to act in such an emergency.

Topics on this page:

• Tonic-Clonic seizures
• Seizures involving altered consciousness or behaviour
• Status epilepticus

Tonic-Clonic seizures

What might happen

The person loses consciousness, the body stiffens, then falls to the ground. This is followed by jerking movements. A blue tinge around the mouth is likely, due to irregular breathing. Loss of bladder and/or bowel control may occur. After a minute or two the jerking movements should stop and consciousness slowly returns.

DO...

• Protect the person from injury - (remove harmful objects from nearby)
• Cushion their head
• Look for an epilepsy identity card or identity jewellery
• Aid breathing by gently placing them in the recovery position once the seizure has finished
• Be calmly reassuring
• Stay with the person until recovery is complete

DON'T...

• Restrain the person
• Put anything in the person’s mouth
• Try to move the person unless they are in danger
• Give the person anything to eat or drink until they are fully recovered
• Attempt to bring them round

Call for an ambulance if... 

• You believe it to be the person’s first seizure
• The seizure continues for more than five minutes
• One tonic-clonic seizure follows another without the person regaining consciousness between seizures
• The person is injured during the seizure
• You believe the person needs urgent medical attention

Seizures ivolving altered consciousness or behaviour

What might happen

Simple partial seizures
Twitching, numbness, sweating, dizziness or nausea; disturbances to hearing, vision, smell or taste; a strong sense of deja vu.

Complex partial seizures
Plucking at clothes, smacking lips, swallowing repeatedly or wandering around. The person is not aware of their surroundings or of what they are doing.

Atonic seizures
Sudden loss of muscle control causing the person to fall to the ground. Recovery is quick.

Myoclonic seizures
Brief forceful jerks which can affect the whole body or just part of it. The jerking could be severe enough to make the person fall.

Absence seizures
The person may appear to be daydreaming or switching off. They are momentarily unconscious and totally unaware of what is happening around them.

DO...

• Guide the person from danger
• Look for an epilepsy identity card or identity jewellery
• Stay with the person until recovery is complete
• Be calmly reassuring
• Explain anything that they may have missed

DON'T...

• Restrain the person
• Act in a way that could frighten them, such as making abrupt movements or shouting at them
• Assume the person is aware of what is happening, or what has happened
• Give the person anything to eat or drink until they are fully recovered
• Attempt to bring them round

Call for an ambulance if... 

• One seizure follows another without the person regaining awareness between them
• The person is injured during the seizure
• You believe the person needs urgent medical attention

Status epilepticus

Status epilepticus is a term used to describe a single prolonged seizure, or a series of seizures which happen with no recovery in between. If the seizure or series of seizures lasts for more than thirty minutes, it is described as status epilepticus.

Any type of seizure may develop into status epilepticus but few do. It is a rare event. There are two kinds of status epilepticus. Tonic-clonic seizures lead to convulsive status epilepticus, which is the most serious form. The other type is non-convulsive status epilepticus and is associated with absence and complex partial seizures. Non-convulsive status epilepticus needs medical attention but is not an emergency in the same way as convulsive status epilepticus. Convulsive status epilepticus is a medical and neurological emergency and urgent medical treatment is needed to stop the seizures.

Some children have medicine prescribed for this emergency, such as rectal diazepam or buccal midazolam. Both of these are relatively simple to administer by a properly trained and willing person. Training in how to administer the medication can often be organised by the local health authority, and should always be given by health professionals such as an epilepsy specialist doctor or nurse. more information

Last updated August 2007