Tonic-clonic (convulsive) seizures first aid

Watch this short video about what to do when someone has a tonic-clonic seizure. All you need to do is CARE.
Stills from first aid video - CARE - Comfort, Action, Reassure, Emergency

Tonic-clonic seizures are the type of seizure most people recognise. They used to be called grand mal seizures. Someone having a tonic-clonic seizure goes stiff, loses consciousness, falls to the floor and begins to jerk or convulse.

They may go blue around the mouth due to irregular breathing. Sometimes they may lose control of their bladder or bowels, and bite their tongue or the inside of their mouth.

Here’s how to help if you see someone having a tonic-clonic seizure.


  • Protect them from injury (remove harmful objects from nearby)
  • Cushion their head
  • Look for an epilepsy identity card or identity jewellery – it may give you information about their seizures and what to do
  • Time how long the seizure lasts
  • Aid breathing by gently placing them in the recovery position once the jerking has stopped (see picture)
  • Stay with the them until they are fully recovered
  • Be calmly reassuring


  • Don’t restrain their movements
  • Don’t put anything in their mouth
  • Don’t try to move them unless they are in danger
  • Don’t give them anything to eat or drink until they are fully recovered
  • Don’t attempt to bring them round


Call for an ambulance if any of these things apply:

  • You know it is their first seizure
  • The seizure lasts for more than 5 minutes
  • They have one tonic-clonic seizure after another without regaining consciousness between seizures
  • They are seriously injured during the seizure
  • They have trouble breathing after the seizure has stopped


Here’s a reminder of the steps to put someone in the recovery position

  1. Put the arm nearest to you at a right angle to the body
  2. Bring the other arm across the person’s chest and tuck their hand under their cheek
  3. Bring the knee furthest away from you into a right angle, so the foot is flat on the floor
  4. Pull on the knee, rolling the person towards you onto their side, whilst protecting their head with the other hand
  5. Adjust the top leg so that it’s at a right angle and the person can’t roll onto their back
  6. Tilt their head back slightly to keep their airway open
  7. Stay with them until they are fully recovered
When to call an ambulance

We are aware of different advice on NHS platforms about when to call an ambulance if someone has a seizure. We recommend following the advice on this page: NHS overview of epilepsy

Published: October 2021
Last modified: May 2023
To be reviewed: January 2023
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