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2.3 First aid

Relevant Tools: A.3
Surveys have suggested that there is a demand from patients for better provision of information, and there is also evidence that this information is especially valued when provided by nurses.1

During a tonic-clonic seizure, bystanders should NOT:1

  • move the person unless he or she is in danger of further injury, for example from fire or traffic
  • try to restrain or restrict movement or lift the person place anything in the mouth or try to give them food or drink.

During a tonic-clonic seizure, bystanders SHOULD:2

  • protect the person from injury by removing harmful objects from nearby
  • cushion the person's head
  • look for an epilepsy identity card or identity jewellery
  • aid breathing by gently placing the person in the recovery position once the seizure has finished
  • stay with the person until recovery is complete
  • be calmly reassuring.

An ambulance should be called if the bystander:1

  • knows it is a person's first seizure, or
  • sees that the seizure lasts for more than five minutes. or
  • observes one seizure appear to follow another without the person gaining consciousness in between. or
  • sees that the person is injured. or
  • believes the person needs urgent medical attention.

The above information is supplied as a poster to help you provide on-the-spot information to people. It can also be displayed in clinic (see A.3).

A small number of patients may be prescribed rescue medication if they have demonstrated a tendency to prolonged or multiple seizures

Buccal midazolam is now licensed for first-line treatment of prolonged seizures in children and young adults. It should be used according to an agreed protocol drawn up by a specialist and only used following training.3 Please note that although this treatment is unlicensed for use in patients over 18 years of age, it may be used on a named patient basis.


1Epilepsy Action, 2011. Generalised seizures. [online] (Accessed 14/012012).

2 Epilepsy Action. 2011. First aid for seizures. [online] (Accessed 14/01/2012).

3 National Institute for Health and Clinical Excellence (NICE), 2012. The epilepsies: The diagnosis and management of the epilepsies in adults and children in primary and secondary care. [CG137]. London: NICE.

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