What Do You Do When Someone Has a Seizure? First-Aid Steps

Protecting the person from injury, timing the event, monitoring breathing, and keeping bystanders back are the main first-aid priorities. Never restrain the person or place anything in their mouth. Call 911 for a seizure lasting five minutes or longer, breathing trouble, repeated episodes without recovery, serious injury, or a first seizure.

These seizure first aid steps apply at home, school, work, and in public. They help you respond safely while recognizing when emergency medical services are needed.

Recognize the Event and Start Timing

Sudden loss of awareness, body stiffening, rhythmic jerking, or confusion can signal a seizure. Start a visible timer at the first sign and record the exact time, observed movements, changes in awareness, and any breathing difficulty.

Not every seizure causes convulsions. Staring, loss of control, unusual stillness, or an abrupt change in awareness may indicate seizure activity, so you should continue observing and timing the event.

Record What You Actually See

A precise observation is more useful than a guessed duration. Note whether the person walks, speaks, responds, stiffens, or jerks, and record when each change occurs.

“Start the timer at the beginning of the activity, not when you reach the person. That detail can prevent several minutes of uncertainty.

Keep the timer where you and another helper can see it. If you joined after the episode began, report when you arrived instead of presenting that moment as the true starting time.

Once the event is being timed, clearing nearby hazards gives the person room while help is arriving.

Create a Safe Space Around the Person

Once you identify the event, scan the area for hazards within the person’s immediate reach. Chairs, tables, stairs, traffic, tools, and sharp or breakable objects can turn involuntary movement into a serious injury.

1. 1Clear hard objects. Move sharp, hard, or breakable items away from the person’s reach without blocking your view or their airway.
2. 2Remove snagging hazards. Loosen a tight collar, necktie, scarf, or other restrictive clothing around the neck if you can do so without pulling on the person.
3. 3Protect the head. Place a folded jacket, cloth, or cushion near or beneath the head when practical, without trapping the neck or limiting chest movement.
4. 4Keep bystanders back. Ask several people to step away so you can observe breathing, movement, and the path for emergency responders.
5. 5Watch from nearby. Remain close enough to respond, but position yourself beside the person rather than over the body.
6. 6Move nearby dangers. Guide a limb away from a hazard only when gentle contact will not interfere with the seizure activity.

For example, a chair rolling toward a person near a curb is a more immediate hazard than an arm moving against the pavement. Move the chair and warn pedestrians rather than trying to stop the person’s arm.

Support Without Restricting Movement

Seizures produce involuntary muscle activity, so applying force can create a joint, neck, or head injury. Protect the person from injury by clearing the space, but let the seizure run its course.

Do Not Hold the Person Down

Never restrain the person’s arms or legs, press their shoulders to the floor, or try to stop the jerking. Gentle support may help with positioning, but it must never prevent normal movement.

You can move an object, support the head, or clear a bystander from the area. You cannot safely end the seizure through physical force, and forceful attempts to wake the person can increase injury risk.

Keep the Mouth Empty

Never put a spoon, bite block, wallet, folded cloth, or your fingers in the person’s mouth. People do not swallow their tongues during a seizure, and an inserted object can break teeth, cut the mouth, or block the airway.

“Appropriate seizure first aid requires no restraint, no objects in the mouth, and no forceful attempts to wake the person.

Stay beside the person and observe the face, chest, and arms as movements continue. Keep a clear route for emergency responders, but do not leave the person alone.

Watch Duration, Breathing, and Awareness

The visible timer turns seizure timing into a fact instead of an estimate. It also shows whether activity has reached the five-minute threshold for an immediate call to 911.

Observe Breathing Throughout the Episode

Watch the chest for rhythmic rises and falls from the beginning of the episode. Call 911 if breathing stops, becomes irregular, or does not appear normal.

During a seizure, the person may be unable to follow instructions because awareness is reduced. Loss of awareness does not justify forcing them to sit or stand, and their safety depends on an open airway and a protected head.

After movements slow, check responsiveness with speech or gentle touch. Do not shake the person, slap their face, or shout forcefully in their ears.

Use the Five-Minute Threshold

A seizure lasting five minutes or longer requires an immediate call to 911. Do not wait for the movements to stop, because prolonged seizure activity can become a medical emergency.

1. 1Five minutes or longer. Call 911 without delay and report the exact time that seizure activity began.
2. 2Repeated episodes. Call 911 as another seizure begins before the person fully recovers.
3. 3Breathing difficulty. Call 911 if breathing stops or does not appear normal.
4. 4Serious injury. Call 911 after a significant fall, head injury, or other major harm.
5. 5Poor recovery. Call 911 if normal awareness does not return after the movements stop.

These rules apply even when the person has a known seizure disorder or epilepsy. A familiar diagnosis does not remove the need for emergency care after prolonged activity, repeated seizures without recovery, breathing trouble, or significant injury.

Recognize When Emergency Help Is Necessary

The five-minute threshold is only one reason to call 911. A seizure may be the first sign of a serious condition, and recovery can reveal an injury or breathing problem that was hidden during the movements.

Call 911 for Higher-Risk Situations

Call 911 for a first seizure, five minutes or more of activity, repeated seizures without recovery, significant injury, or breathing difficulty. Pregnancy and known diabetes with uncertain recovery also warrant emergency assistance.

Suppose the person’s movements stop, but the person remains unresponsive and the chest is not rising normally. Follow the dispatcher’s instructions for emergency medical support rather than checking a pulse or attempting procedures you are not trained to perform.

A seizure near water, a staircase, a roadway, or a steep drop requires emergency medical services even if the movements stop. The location may hide a fall, near-drowning risk, spinal injury, or another danger that normal recovery does not rule out.

Give the Dispatcher Clear Facts

Remain on the line and answer the dispatcher’s questions. Keep the person in view, or have another helper watch them during the call if one is available.

• ▸Exact location: Give the street address, building, floor, room number, or a nearby landmark.
• ▸Starting time: Read from the timer rather than estimating how long the episode has lasted.
• ▸Observed activity: Describe jerking, stiffness, loss of awareness, unusual stillness, or attempted movement.
• ▸Breathing status: State whether the chest is moving normally, irregularly, slowly, or not at all.
• ▸Repeated events: Report each episode and the time recovery began between them.
• ▸Relevant details: Mention pregnancy, diabetes, injury, or a prior seizure when relevant to the person’s condition.

Clear observations help the dispatcher plan the response. Protecting the person from injury, recording the time, and watching breathing are priorities that align with public seizure first aid guidance from the Centers for Disease Control and Prevention.

If emergency help is not yet needed, protecting the person’s airway as they recover is the next practical priority.

Position the Person During Recovery

When the jerking stops, the immediate risks shift toward breathing, aspiration, injury, and another seizure. You should check breathing and remain beside the person throughout post-seizure recovery.

Use the Recovery Position

Turn the person onto their side after the movements stop when it is safe to do so. The recovery position helps keep the airway open if saliva or vomit is present.

Place a cushion under the head only when it keeps the neck aligned and leaves the face uncovered. Do not use an object to prop the person upright or obstruct the mouth.

Someone who becomes confused and tries to sit immediately after jerking may fall again. Stay close, speak calmly, and prevent another fall without holding the person down.

Monitor Until Recovery Is Clear

Keep watching until the person is alert, breathing normally, and moving safely. Post-seizure recovery may include confusion, tiredness, headache, memory gaps, or temporary difficulty responding.

Do not offer food, drink, or any medical product until the person is fully alert and able to swallow safely. Worsening confusion, breathing difficulty, a new seizure, or failure to return toward usual function needs prompt medical attention.

“Recovery is not over as soon as the jerking ends. Stay until the person is alert, breathing normally, moving safely, or in the care of emergency responders.

Speak in short, simple sentences. Say that the seizure has ended and that you are staying nearby, then allow time for the person to respond without crowding them with questions.

Use the Individual Seizure Action Plan

A written plan that explains how to support breathing safely after an episode can make emergency response more effective. The plan may identify usual triggers, describe normal recovery, list emergency contacts, and explain who should be notified.

Follow Known Instructions Carefully

Ask a family member, caregiver, school staff member, or coworker about the person’s prescribed plan and medical alert instructions. A plan cannot replace a call to 911 after a prolonged seizure, breathing difficulty, serious injury, or poor recovery.

Use the plan’s medication directions as written and do not give an unprescribed product during the episode. If instructions conflict with emergency warning signs, call 911 and report the concern to the dispatcher.

Record the starting time, ending time, visible movements, breathing changes, injuries, and recovery. Include repeated episodes and the time between them because that sequence can help the person and an appropriate specialist doctor identify patterns.

Coordinate Follow-Up After an Event

Keep the person under observation until they are alert, can move safely, and return to their usual level of functioning. Brief confusion may persist, but worsening confusion or failure to recover needs medical evaluation.

At a workplace or school, follow the organization’s emergency procedures. A supervisor, school nurse, designated first responder, or family contact may need to know what happened and whether further assessment is required before normal activities resume.

For a person with epilepsy, regular follow-up with a qualified healthcare professional helps keep the written plan current. Share changes in seizure duration, breathing, recovery, or injury patterns during those visits.

Bottom Line

Stay calm, start timing, clear hazards, and allow the movements to continue without restraint. Your priorities are to protect the person from injury, avoid placing anything in the mouth, and observe breathing.

Call 911 for five minutes or longer of activity, repeated seizures without recovery, breathing difficulty, serious injury, pregnancy, or a first seizure. After movement stops, use the recovery position when safe and remain nearby until the person recovers or responders take over.

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