First Aid for Seizures

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Introduction

As a service provider, you may work with consumers who have seizures. Training in seizure management is very important for all staff in residential programs, day services, schools, or any other program serving consumers with developmental disabilities.

There are many misconceptions about how to assist a person who is experiencing a seizure. These misconceptions may lead to serious consequences for the consumer. You may find the following checklist useful to help you remember what you should do if someone you are working with has a seizure. This checklist may be copied and used for staff training and posted, as appropriate.

The National Institutes of Health recommends the following:

If you see someone having a seizure

• Roll the person on his or her side to prevent choking on any fluids or vomit.
• Cushion the person’s head.
• Loosen any tight clothing around the neck (i.e. necktie or buttons).
• Provide privacy.
• DO NOT restrict the person from moving unless he or she is in danger.
• DO NOT put anything in the person’s mouth, not even medicine or liquid. These interventions can cause choking or damage to the person’s jaw, tongue, or teeth. Contrary to widespread belief, a person cannot swallow his tongue during a seizure or any other time.
• Remove obstacles in the area that the person might hit during the seizure.
• Observe to see that the person’s airway remains open.
• Staff should note how long the seizure lasts and what symptoms occurred so you can tell a doctor or emergency personnel, if necessary.
• Remain with the person until the seizure ends.

Many people recover from a seizure and require no further assistance or treatment. However, there are circumstances when it is extremely important to Call 911 for emergency assistance.

Call 911 if:

• The person is pregnant or has diabetes.
• The seizure happened in water.
• The seizure lasts longer than five minutes.
• The person does not begin breathing again and return to consciousness after the seizure stops.
• Another seizure starts before the person regains consciousness. Prolonged or clustered seizures sometimes develop into non-stop seizures, a condition called status epilepticus. Status epilepticus is a medical emergency. Call 911.
• The person injures himself or herself during the seizure.
• This is the first seizure or you think it might be. If in doubt, check to see if he or she has a medical identification card or medical alert jewelry stating that he or she has epilepsy or a seizure disorder.

Observations

During and after a seizure, make observations and record them so the healthcare provider will have complete information. Answer the following questions:

• Did the person have an “aura”? An aura may be described as the person reporting a particular sensation or feeling. They may report smelling a particular odor or seeing a particular color, pattern, or light just before the seizure.
• When and how often did the seizure(s) occur?
• Did the person lose consciousness?
• How long did the seizure last?
• Did the person have multiple seizures?
• Did the person lose bowel or bladder control or stop breathing?
• How did the person behave during the period of recovery following the seizure?

In addition, there are many, highly useful sources for other educational materials available on the Internet. For example, posters and other tools such as bulletins can be downloaded from The Epilepsy Foundation.

Consider seizure management training as a subject for staff meetings or other staff development initiatives. Invite a speaker from your local Epilepsy Foundation or another person with knowledge of seizure management.