In this lesson, you'll learn how to treat a child or adult who goes into a seizure or has just come out of one, including when to call 911.
A person can have a seizure for too many reasons to mention. As you are concerned, why it happened isn't important. Being able to recognize it and treat it is the key.
For you to know if a seizure took place, ideally you or someone else saw the patient go into a tonic state that exhibited the following signs:
- Hands are gripped and pointed inward
- The patient is actively seizing
- The patient ends the seizure in the postictal state (relaxed recovery)
Pro Tip #1: Some seizure victims will be known epileptics and many of the people around them will probably know how to care for one and have been through it before. But if you're helping a person you don't know to be an epileptic, treat this event as the person's first seizure.
How to Provide Care
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.
However, if the victim is in the middle of a seizure, you'll want to start with the following:
- Call 911 and activate EMS. (Or better yet, ask a bystander to do it while you help the victim.)
- Protect the victim from any environmental hazards, like sharp objects.
Pro Tip #2: There are many different types of seizures, some of which can be more active than others and involve the victim violently contracting and releasing. It's also quite common for a seizure victim to hit his or head on the floor or ground while seizing.
Warning: Never try to hold down or prevent a seizing person from a having a seizure. All you can do for them is to keep them safe during the episode.
- Place something under the seizing victim's head like a coat or hoodie or even your hand.
- After the seizure has passed, begin a secondary assessment of the victim. Do you notice any major injuries or airway obstructions? Are there any other potentially life-threatening issues?
- Get the victim into a recovery position.
The Recovery Position
To help keep the victim's airway open and clear, put them into the following recovery position. You want gravity to work with you, as there could be saliva, blood (if the victim bit his or her tongue), or eventually vomit that may need to come out, rather than back into the victim's airway.
- Elevate the arm closest to you and bring it up over the victim's head before placing it on the ground.
- Bring the victim's furthest leg over their other leg so that their legs are crossed.
- Grab the wrist of the furthest arm and the hip together, while placing your other hand under the head and neck and roll the victim toward you and onto their side.
Pro Tip #3: Always roll the victim toward you, not away. You'll have better control over them and will be much less likely to accidentally roll them too far and onto their face. Plus, being able to see their face could be important for visual clues of how they're doing.
- Support the head while you place the victim's outstretched arm under their own head and with the chin pointing down, allowing gravity to help clear the airway.
- Bend the victim's top leg to a 90-degree angle at the knee, essentially creating a kickstand to help protect the victim from rolling over.
While waiting for EMS to arrive, continue to assess the victim for breathing and recovery signs, like talking. Any signs that the person is becoming more responsive are good signs.
Remember, if the victim begins showing signs of shock – cool, pale, sweaty skin and a rapid pulse – cover him or her with a sheet, coat, or blanket and keep them as warm and comfortable as possible while waiting for EMS to arrive.
A Few Common Questions About Seizures
What about putting something into the victim's mouth to keep them from biting or swallowing their tongue?
This practice is no longer recommended. DO NOT put anything into a seizing person's mouth. All you can do is keep them comfortable and safe during the ordeal.
What if the person stops breathing while in the recovery position?
If there any problems at all – the victim isn't breathing normally, loses a pulse, loses consciousness, etc. – roll them back onto their back and treat them accordingly.
If the person stops breathing but still has a pulse, perform rescue breathing. If the victim stops breathing and loses his or her pulse, begin full CPR.
Why do seizure victims seem confused after a seizure?
A person who has just experienced a seizure – essentially an electrical storm in the brain – will be low on oxygen. As a result, they may be confused or combative and this will likely last a few minutes.