Seizure First Aid: What to Do

Every year on Purple Day (26th March), Australians join a global movement to raise epilepsy awareness. It’s a day to get people talking about epilepsy and to dispel fears and myths​. One of the most empowering ways to participate is by learning seizure first aid. Epilepsy affects around 250,000 Australians​, so chances are you might witness a seizure at some point. Knowing what to do can make anyone a Purple Hero – someone who steps up to keep a person safe during a seizure. This guide will walk you through step-by-step seizure first aid, explain when to call an ambulance, bust common myths (no, you should not put anything in their mouth!), and answer FAQs. With a calm approach and the right knowledge, you can truly help someone in need.

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Why Seizure First Aid Matters

Seeing someone have a seizure can be scary, but staying calm and informed makes all the difference. Most seizures last only a minute or two and end on their own​. However, the person could injure themselves during a convulsive seizure (for example, by hitting their head or choking on something nearby). That’s why your quick action to protect them is so important. By knowing seizure first aid, you’ll be prepared to:

• Keep the person safe from injury during a seizure.
• Provide comfort and reassurance as they recover.
• Know when to call for emergency help if the seizure doesn’t self-resolve or if it’s a dangerous situation.

Purple Day is all about ordinary people becoming heroes for those with epilepsy. By learning how to help someone having a seizure, you can be a part of this mission. It’s not about medical expertise – it’s about compassion, safety, and understanding. Let’s start by recognizing what a convulsive seizure looks like and then go through the first aid steps.

Recognising a Convulsive Seizure

Not all seizures look the same, so this guide focuses on the convulsive type (the kind most people think of when they hear “epileptic fit”). A convulsive seizure – often a tonic-clonic (or “grand mal”) seizure – typically has two phases​:

• Tonic phase: The person suddenly loses consciousness and their body goes rigid. They may let out a brief cry or groan as air is forced out and then fall to the ground if standing.
• Clonic phase: Rapid, rhythmic jerking of the muscles begins – the person’s arms and legs jerk or twitch uncontrollably. They might shake or convulse on the ground. Breathing can become irregular during this phase, and you might see excess saliva or foaming at the mouth, or hear gurgling noises. They may also bite their tongue, which can result in a bit of blood in the saliva (this is common and usually not severe).

During a convulsive seizure, the person will be unresponsive – they are not aware of what’s happening. Their eyes might roll back or stare blankly, and skin could flush or look a bit blue-ish (especially around the lips) if breathing is briefly irregular.

It’s important to remember that seizures usually stop on their own within a few minutes. The convulsions will slow down and then cease. At that point the person enters a recovery phase (often called the post-ictal phase) where they may be confused, sleepy, or disoriented. They might not remember the seizure at all.

Bottom line: If you see someone suddenly collapse, stiffen, and begin convulsing, they’re likely having a tonic-clonic seizure. Now, let’s go through exactly what you should do, step by step, to help them.

Step-by-Step: Seizure First Aid

If someone is having a convulsive seizure, follow these steps to help keep them safe. Remember to stay calm and act with confidence – your presence and actions can significantly help the person.

1. Stay with the person and keep calm. Your first instinct might be panic, but take a deep breath and focus. Stay with the person throughout the seizure. Keeping calm helps others around you stay calm too. Note the time the seizure starts – use a watch or smartphone clock if possible. Timing is important because if the convulsions go on too long (over 5 minutes), it becomes an emergency.
2. Protect them from injury. Gently ease the person to the floor (if they aren’t already on the ground). Clear the area around them – remove any hard or sharp objects like furniture, glass, or hot liquids that could hurt them. If you can, place something soft under their head (like a folded jacket or pillow) to cushion it. Loosen any tight clothing around their neck (ties, scarves, collars) to help them breathe and prevent choking. Do not hold them down or try to stop the movements – you can’t stop the seizure, and restraining can cause injuries​.
3. Don’t put anything in their mouth. This is a critical safety point (and a common myth we’ll debunk later). Never place any objects, fingers, or food/drink in the person’s mouth during a seizure. They will not swallow their tongue – in fact, it’s physically impossible to do so​. Forcing something into their mouth could chip their teeth, cause jaw injuries, or block their airway. So keep the mouth clear and just let the person breathe naturally. They might bite their tongue, but that usually heals on its own and is not life-threatening.
4. Time the seizure. Keep an eye on the clock. If the convulsive part of the seizure lasts longer than 5 minutes, call an ambulance (more on that below). Most seizures will stop well before that. Note the duration and what you observed, as this information can help medical professionals or the person’s doctor later.
5. Roll them onto their side (recovery position) when safe. If possible, turn the person onto their side once the convulsions subside. This is the classic recovery position – it helps keep their airway open and lets saliva or vomit drain out to prevent choking​. (If you notice the person vomiting or having fluid in their mouth during the seizure, and you’re able to safely roll them on their side then, do so immediately​.) Typically, it’s easiest to wait until the jerking stops, then gently roll them onto their left side. Tilt their head back slightly to keep the airway clear.
6. Check their breathing. Once on their side, check that the person is breathing normally. After a seizure, it’s normal for breathing to be a bit irregular or loud at first, but they should be breathing effectively. Loosen any restrictive clothing and make sure their airway is open. If they aren’t breathing at all for several seconds after the convulsions have stopped, or you suspect they inhaled water/food, seek emergency medical help (and be prepared to start CPR if breathing doesn’t resume). In almost all cases, the person will resume normal breathing on their own as they recover.
7. Stay with them and reassure them as they wake up. When the seizure is over, the person will regain consciousness gradually. They may be confused, disoriented, embarrassed, or very tired. It’s also possible they might have a headache or soreness. Stay by their side and speak to them calmly and gently. Let them know they are safe and that you’re there to help. Often people are dazed and might not know what happened or where they are for a few minutes. Gently explain that they had a seizure and that they should rest. Do not give them food, water, or pills until they are fully alert and any nausea has passed​, as they could choke. If they fell asleep (it’s common for people to want to sleep after a seizure), simply keep an eye on their breathing and let them rest.
8. Ensure they are fully recovered before leaving. Stay with the person until they have recovered enough to safely care for themselves. “Recovery” means they are awake, alert, and able to respond normally. Once they’re steady on their feet (if they stood up) or able to sit up and talk, you can help them figure out what they might need next – whether it’s a ride home, a phone call to a family member, or a visit to the doctor. It’s a good idea to make sure someone can go home with them or check on them, especially if this is their first seizure or if they got hurt​.

Those are the basic first aid steps for a convulsive seizure. In many cases, following these steps is all that’s needed until the person is feeling better. Next, let’s highlight a few crucial things not to do during a seizure – these are common misconceptions we want to avoid.

What Not to Do: Common Myths

Unfortunately, some outdated first aid ideas are still around. It’s important to avoid certain actions during a seizure, as they can do more harm than good. Here are the top myths and what not to do:

• Don’t put anything in their mouth. We mentioned this above, but it’s worth repeating because it’s a very common myth that you should force something (like a spoon, wallet, or even your fingers) into a seizing person’s mouth to stop them from “swallowing their tongue.” This is a myth. It is impossible for someone to swallow their tongue during a seizure​. The tongue is attached to the bottom of the mouth. Trying to pry their mouth open can chip teeth or cause you to get badly bitten. The correct approach is to keep the airway clear – turning them on their side allows saliva to drain. But never stick objects or fingers in the mouth. As Healthline puts it: placing something in the mouth of a person having a seizure is dangerous​. You won’t help them – you might injure them (or yourself).
• Don’t hold them down. You might feel tempted to restrain the person’s movements, especially if the convulsions look violent. However, do not try to hold the person down or stop the jerking​. You won’t be able to stop the seizure, and restraining them can cause muscle injuries or even bone injuries. Let the seizure run its course while making the environment safe (as described in the steps above). If you gently cradle their head or shoulders to prevent a fall, that’s fine – just don’t pin or wrestle them.
• Don’t move them (unless truly necessary). It’s best not to move a person during a seizure unless they are in a dangerous location. For instance, if someone is convulsing on a road or next to a hot stove, you’d carefully drag them to a safer spot. Otherwise, don’t move them until the seizure is over​. Moving a person during a convulsion can risk injury to you both. Just clear objects away and let them be where they are.
• Don’t give food, drink, or medication during the seizure. Absolutely do not try to give them water or food while they are seizing or not fully conscious – they could choke. Wait until they are fully alert and able to swallow safely​. Similarly, do not try to administer any pills or extra doses of their epilepsy medication during the seizure. Emergency medications for seizures (like midazolam or diazepam nasal sprays/injections) should only be given if you are trained, and according to the person’s seizure management plan or ambulance operator instructions.
• Don’t panic or run away. This might sound obvious, but staying with the person is crucial. Your calm presence can prevent bystanders from panicking and helps the person feel supported when they come out of the seizure. You don’t need to be a medical expert – just follow the steps. Remember, seizures generally end within a couple of minutes on their own. Staying until the person is okay is part of proper first aid.

By avoiding these common mistakes, you’ll ensure that you’re truly helping the person. Next, let’s talk about when a seizure is more than just a brief episode – when do you need to call an ambulance?

When to Call an Ambulance

Not every seizure requires an ambulance. Many people with epilepsy have a care plan and may not want or need to go to hospital after a typical seizure. However, there are certain situations where calling Triple Zero (000) for an ambulance is essential​. Use the following rules of thumb, and when in doubt, it’s better to call. Call an ambulance if any of these apply:

• The seizure lasts longer than 5 minutes. A convulsive seizure that goes beyond five minutes is a medical emergency. Prolonged seizures (known as status epilepticus) can be life-threatening. If you timed the seizure and it’s around the 5-minute mark with no signs of stopping, call 000 immediately. (If you’re not able to time it exactly, and it just feels “very long,” err on the side of calling for help.)
• Another seizure follows quickly. If the person has a second seizure soon after the first one, without regaining consciousness in between, call an ambulance​. Two or more seizures in a row (a series of seizures) is also an emergency situation.
• The person is injured or in danger. Call for help if the person hurt themselves badly during the seizure – for example, a serious head injury, cut, or broken bone. Similarly, if the seizure happened in a dangerous situation (like in water, on heights, or in traffic), or if they’ve inhaled water or food, get medical help. Seizures in water are especially risky – even if the person seems to recover, they need medical check because of possible inhalation of water​.
• They have trouble breathing after the seizure. It’s normal for someone to take a big breath or even cough as they come out of a seizure. But if the person is not breathing or has serious breathing difficulties a minute or two after the convulsions stop, call an ambulance​. (In the rare case they don’t start breathing at all when the seizure ends, you should call 000 and begin CPR as needed​.)
• They don’t wake up after 5 minutes of the seizure ending. Some post-seizure grogginess or sleepiness is normal, but the person should gradually wake up and become responsive within a few minutes. If they remain unconscious, unresponsive, or extremely confused for more than about 5-10 minutes after the seizure has stopped, they need medical attention​.
• It’s their first ever seizure. If you don’t know the person or you know this is the first time they’ve ever had a seizure, it’s safest to call an ambulance​. First-time seizures need medical evaluation to determine the cause and to prevent future ones. The same goes if the person doesn’t have a known epilepsy diagnosis – for example, if a friend or colleague with no history of seizures suddenly has one, treat it as an emergency.
• You’re not sure or feel uncomfortable with the situation. When in doubt, call 000​. Emergency operators can also give you guidance on what to do until paramedics arrive. It’s better to get professional help if you’re uncertain about the person’s condition (for instance, if the seizure behavior is unusual or you suspect something else is wrong).

Remember to stay with the person until the ambulance arrives, if one is on the way. Continue to monitor their breathing and keep them on their side. By providing detailed information to paramedics (duration of seizure, what it looked like, any injuries or odd symptoms), you’re helping ensure they get appropriate care.

Most of the time, seizures resolve without needing hospital care. But knowing the red flags helps you make the right call. Next, we’ll discuss what happens after the seizure and how you can support the person in the minutes or hours following.

After the Seizure: Recovery

When the convulsions have stopped and the person is in the recovery phase, your role is to ensure they recover safely and feel supported. Here’s what to do after the seizure:

• Keep them in the recovery position on their side, and continue to check their breathing. It’s okay if they remain unconscious or fall asleep for a short while – this can be the brain’s way of recuperating. Just make sure their airway is clear. If they try to get up too soon, gently discourage them until they’ve had a bit of time to rest.
• Speak softly and offer reassurance. As they start to come around, they may be confused, frightened, or upset. Use calm, simple language. You might say, “You had a seizure, but you’re okay. I’m here with you. Just rest for a minute.” Tell them the seizure is over and they’re safe. Reorient them to where they are and what happened, if they ask – for example, “You’re at work and you had a seizure. An ambulance isn’t needed, you’re just resting now.”
• Check for injuries. Once they are awake and mobile, do a quick check: Are there any cuts, bumps, or bruises from the fall or convulsions? If they bit their tongue, there might be a bit of blood in their mouth – offer them a tissue. Most seizure-related injuries are minor (tongue bites, bruises). If you suspect a more serious injury (like a dislocated shoulder or a bad head bump), or the person is in pain, seek medical advice (call their doctor or in serious cases, an ambulance if not already called).
• Stay with them until they’re fully alert. Don’t leave a recovering person alone. They might be unsteady or groggy for a while (some people take 10-20 minutes to feel normal, others might need an hour or so). If you’re in a public place, ensure someone trusted is with them or that they can get home safely. If at work or school, have them sit out and rest until recovered. It can help to offer a small sip of water once they are fully awake and can swallow, since they might have a dry mouth or be a bit dehydrated – but only do this when you’re sure they’re alert enough.
• Provide privacy and comfort. Waking up from a seizure can be embarrassing for the person, especially in a public or work setting. If a crowd has gathered, politely ask people to give space. Help the person cover up if any clothing was loosened. Let them sit somewhere quiet and calm. Avoid dramatic reactions – speak to them normally and respectfully.
• Follow any seizure action plan if available. If the person has epilepsy, they might have a written Seizure Management Plan or medical instructions (sometimes carried on a phone or MedicAlert bracelet). This could include specific steps like giving a rescue medication after X minutes or calling a specific family member. If such a plan is available, follow it. If the person is wearing a medical bracelet or ID, check it for info – it may say something like “Epilepsy – if seizure >5 min call ambulance” etc.
• Document or remember details. It might be helpful to write down what happened (for the person or their doctors). Note the date/time, how long the seizure lasted, what you observed (e.g. “stiffened, then full-body jerking for 2 minutes, unconscious for 3 more minutes, then woke up confused”). This can be valuable information for the person’s medical follow-up. If you are a colleague or teacher, your workplace/school might have an incident form to fill. In any case, make sure the person knows what you witnessed, once they are ready to talk.

The key in the aftermath is being patient and kind. The person may feel tired for a while (it’s not unusual for someone to need a few hours of rest or sleep after a severe seizure). If they feel okay once fully awake, you can help them arrange a way to get home safely. They should avoid activities like driving or operating machinery for some time after a seizure (in fact, in Australia, a person typically isn’t allowed to drive for a period after a seizure – they should consult their doctor about this).

Most people will recover well with just rest and reassurance. But this is also the time to consider any next steps, like seeing a doctor or adjusting medication, especially if it was an unexpected or out-of-pattern seizure.

Follow-Up and Ongoing Care

After providing first aid and ensuring the person is safe, you might wonder what comes next. In many cases, especially if the person has known epilepsy, they may just continue with their day after resting. However, certain situations warrant medical follow-up:

• If this was the person’s first seizure: They absolutely should see a doctor. A first seizure could be a sign of an underlying medical issue that needs treatment. Encourage them to get a medical check-up. This might involve seeing a GP for referral to a neurologist, having tests like an EEG or MRI, and discussing starting anti-seizure medication.
• If seizures have been happening more often or changing: If you know the person has epilepsy but this seizure was longer or different than their usual ones, suggest that they contact their doctor. Their treatment plan might need adjusting.
• If they were injured or have any lingering symptoms: Obvious injuries should be treated (cuts cleaned, etc., or hospital care for serious trauma). If after an hour or two the person still feels very unwell (for example, severe headache, confusion, or weakness in one side of the body), they should get medical attention the same day.

One convenient option nowadays is telehealth. Services like NextClinic allow people to see a doctor online from home. This can be helpful after a seizure – for instance, if the person needs a medical certificate for work or school, a quick GP consultation for advice, or a referral to a specialist, it can often be done via an online appointment. NextClinic’s Australian doctors can assess the situation, provide prescriptions (e.g. anti-epileptic medication or emergency medication if needed), and give referrals to neurologists for further investigation, all through a video call. This is a practical step especially if the person cannot drive (which is common after a seizure) or feels too fatigued to travel to a clinic.

Lastly, educating yourself and others is part of ongoing care. Share what you’ve learned about seizure first aid with friends and family. The more people know what to do, the safer our community becomes for everyone with epilepsy. As Purple Day reminds us, awareness and understanding can save lives. Anyone can be a Purple Hero – including you!

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Disclaimer

This medical blog provides general information and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your regular doctor for specific medical concerns. The content is based on the knowledge available at the time of publication and may change. While we strive for accuracy, we make no warranties regarding completeness or reliability. Use the information at your own risk. Links to other websites are provided for convenience and do not imply endorsement. The views expressed are those of the authors and not necessarily representative of any institutions.