First Aid for Seizures

The event can be frightening for onlookers – a person collapsing and shaking violently, unable to talk and possibly vomiting and losing other bodily functions. These types of seizures often occur without warning, and if the victim is alone in a public place, witnesses may not understand what is happening, nor be able to effectively and safely help the person experiencing the seizure.

Neurologist Alberto Pinzon, M.D., Ph.D., medical director of the Epilepsy Program at Baptist Health Neuroscience Center says seizures, like these, are known by the clinical term “general tonic-clonic” seizures or what used to be referred to as “grand mal.” There are other types of seizures as well, according to the Centers for Disease Control and Prevention (CDC), and they are quite common. In fact, the CDC reports that one in 10 people will experience some type of seizure over their lifetime.

Dr. Pinzon notes that the tonic-clonic variety is best known because of the dramatic display of its symptoms. “It can be traumatic for witnesses to see these seizures, because they appear to cause the patient pain,” he said. “The reality is that the person having the seizure is unaware of what is happening.”

Causes of Seizures

Dr. Pinzon says that seizures are caused by abnormal electrical activity in the brain, resulting from the misfiring of neurons, which release chemicals known as neurotransmitters. He explains that those “misfiring” can be provoked by medications, illicit drug activity and metabolic imbalances, as well as the body’s response to other events or substances. On the other hand, unprovoked seizures can result from certain brain conditions, including tumors, stroke, congenital abnormalities and others.


According to Dr. Pinzon, when a person experiences two or more unprovoked seizures that occurred more than 24 hours apart, he or she is considered epileptic . Epilepsy, if diagnosed, may be managed with medications. Still, those medications may fail or an epileptic may forget to take them, resulting in a seizure.

Witnessing a Stranger’s Seizure

“The problem when strangers witness a seizure is that they don’t know the person’s medical history and whether or not he or she has epilepsy,” Dr. Pinzon said. “They may not even understand the person is having a seizure.” Here are the steps that Dr. Pinzon recommends if you witness someone having a seizure:

  • Call 911 – If someone collapses with jerking motions, Dr. Pinzon suggests having someone call 911 immediately while the following actions are taken.
  • Protect the airway – Position the person on his or her side. Dr. Pinzon says this allows any fluid – including saliva, vomit or blood – to drain from the mouth, preventing the person from choking on these fluids. Also, the CDC advises witnesses to remove neckties, scarves or jewelry from around the neck to minimize risk of injury.
  • Protect the head and body – Place a pillow or soft garment under the person’s head and clear the area of any objects that the person may contact during the seizure. The CDC also recommends removing any eyeglasses from the victim’s face.
  • Time the seizure – Dr. Pinzon says that with most seizures, the convulsing stops in two to three minutes. If a seizure lasts longer than that, brain damage could set in and paramedics will need to have that information when they arrive on the scene.
  • Do not put anything in the person’s mouth – Dr. Pinzon dispels the myth that you should put something in the mouth to prevent the person from biting or swallowing his or her tongue. “The human mouth is very strong and you can end up with a severe bite or cause the person to choke,” he advised.
  • Stay with the person – When the seizure is over, the person will likely be confused and lethargic. Stay with the person until paramedics arrive and let them know what you witnessed.
Seizures of Known Epileptics

If you know a person has epilepsy and you witness a seizure, Dr. Pinzon says it may not be necessary to call 911. “If the person has a known epilepsy diagnosis, follow the above steps without calling paramedics, unless the seizure lasts longer than 2 minutes and there’s worry about brain damage,” he said. Often, epileptics will have medications to stop seizures while they are happening.

After the seizure, when the epileptic patient is safely recovering, Dr. Pinzon recommends reporting the seizure to the patient’s neurologist to help determine the need for any follow-up care.

Returning to Normal

Dr. Pinzon notes that victims of seizures do not remember their seizures, but witnesses do and can experience traumatic effects for some time after the event has passed. For these people, he advises seeking counseling from a trusted professional, especially if it seems difficult to stop any physical reactions to the memory of the event. “People may not realize the lasting effect that witnessing an event like this has on their own health,” he said.

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