What to Do If Someone Has a Seizure: Helpful Steps You Can Follow

If you’ve ever witnessed someone having a seizure, it can be a really scary experience. It can be hard to think fast and know what to do, especially if it’s the first seizure you’ve seen. But seizures are actually more common than many people may realize. In fact, 1 in 10 people will have a seizure at some point in their life. 

There are a few simple guidelines you can follow to help someone when it happens. In this article, we’ll help you learn how to recognize a seizure — and what you can do to help.

What does a seizure look like?

In order to recognize a seizure, it helps to first understand what a seizure is. Your brain uses electrical activity to work properly. These electrical impulses coordinate and control movement. Examples of this are moving your legs so you can walk, or moving your mouth so you can talk or chew.

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A seizure occurs when that electrical activity short circuits and becomes disorganized. Not everyone will have a seizure. However, every brain has the potential to have one. Each person just has a different threshold for stressors that may trigger a seizure.

Common seizure symptoms

Seizures can look very different depending on where the short circuit in the brain starts. A person may be experiencing a seizure if they have any of the following symptoms:

• Jerking movements: This is probably the symptom that most people associate with a seizure. It looks like rhythmic jerking in the arm, leg, or the entire body.

• Stiffness: Rather than jerking movements, someone who’s having a seizure may appear like all their muscles are rigid or stiff.

• Unresponsive or staring episode: Sometimes, this can be subtle, and the person may just look confused or dazed. 

• Lip smacking: The person may only have subtle movements of their lips or mouth.

• Limpness: Sometimes, people may suddenly become completely limp. This is a less common type of seizure.

• Sleepiness or confusion afterward: After the brain experiences the flurry of electrical activity that causes a seizure, it usually takes some time to recover and return to normal. This usually means someone may be really sleepy or confused right after the seizure. This tends to improve over the course of minutes. 

What to do if someone has a seizure

When you witness the above symptoms or think someone may be having a seizure, there are some things you can do to help keep them safe. No matter what kind of seizure they’re having, you can follow these steps.

Step 1 

Ease them to the floor. This helps prevent any injury from falling off a chair or couch. If someone’s having a seizure in bed, make sure they aren’t near the edge. 

Step 2

Loosen their shirt collar or tie. This prevents constriction of the neck and keeps their airway clear, allowing them to breathe more easily. If they’re wearing a mask, remove that as well. 

Step 3

Turn them on their side. Sometimes, the person may have something in their mouth or vomit after a seizure. Keeping them on their side also helps to keep their airway clear.

Step 4

Clear the area. Move furniture and other large objects out of the way. This helps to prevent other injuries that can result from involuntary jerking. 

Step 5

Put something soft and flat under their head. Sometimes, a person may also have some jerking to their heads. This can help cushion their head. Thin items are better, so try to avoid a fluffy pillow. Any bend in the neck may cut off their airway.

Step 6

Remove their glasses. Removing glasses and other loose objects around their face allows the person to breathe more comfortably and prevents other injuries. 

Should I call 911?

The short answer is, yes. If there are other people nearby who can help, ask one of them to call 911 while you stay with the person. But the first step is always to make sure the person seizing isn’t in any immediate danger. So, if you’re by yourself, it’s OK if you can’t call 911 right away.

When to call 911 for a seizure

Make sure you call 911 as soon as possible in the following cases:

• The seizure lasts longer than 5 minutes. 

• You notice that the person seizing has bluish lips or fingertips. 

• The person doesn’t slowly wake up after the seizure, or they have a second seizure afterward. 

• The seizure occurred in water. 

• The person has an injury from the seizure.

• You know the person has an underlying medical condition such as heart disease, diabetes, or pregnancy. 

For people who have epilepsy or repeated seizures, their caregivers sometimes know whether or not they need to call 911. But if there’s any doubt, it’s always best to call 911.

Medications to stop seizures

There are several medications used to treat seizures. Which medication to use depends on a lot of different factors. Let’s take a look at some of the most common medications used to stop seizures below.

Benzodiazepines

These are often first-choice medications used for stopping an active seizure. Benzodiazepines (or “benzos”) help calm the extra electrical activity in the brain during a seizure. Common benzos used for seizure control include:

• Clonazepam (Klonopin)

• Diazepam (Valium)

• Lorazepam (Ativan)

• Midazolam (Versed)

Phenobarbital

If benzos fail to stop a seizure, healthcare professionals sometimes use phenobarbital next. Like benzos, phenobarbital also causes a calming effect on the brain. Phenobarbital is the preferred seizure medication for seizures caused by alcohol withdrawal.

Propofol

Normally used as a sedative, propofol is also sometimes used for stopping seizures. If benzos and phenobarbital fail to stop a seizure, healthcare professionals can use propofol to effectively shut down the brain, causing the seizure to stop.

Levetiracetam

Patients who have one seizure are at a high risk of having more seizures in the hours to follow. Levetiracetam (Keppra) is given to patients after an active seizure has stopped to help prevent further seizures from occurring.

What NOT to do for a person having a seizure

There are several things that you shouldn’t do for a person who’s having a seizure. These actions can increase the risk of injury or harm. When someone has a seizure: 

• Don’t try to hold them down.

• Don’t place objects in their mouth.

• Don’t try to give them something to eat or drink immediately afterward.

What to do after someone has a seizure

As a person is recovering from a seizure, it takes a little time for them to return to normal.

Right after the seizure, they often don’t open their eyes or speak. Usually, they’ll slowly regain consciousness over the course of minutes. During this period, they may seem confused or not sure about what happened.

Many times, the recovery from a seizure lasts longer than the seizure itself. If you can, it's important to stay with the person during both the seizure and recovery period. There are several things you can do to help in this phase too.

Keep these things in mind when someone’s recovering:

• If they’re confused, it helps to calmly explain what happened and remind them that they’re safe.

• It’ll likely take a while for them to regain their strength. You can help them sit up. And when it’s time, help them try to stand.

• If it isn’t their first seizure, they may have seizure medication that they take regularly. Ask if they need any help getting their medication.

• If you haven’t already called 911, they may tell you not to call. Ask if you can still help them safely seek medical attention.

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Written by:

Jill L. Jaimes, MD

Jill L. Jaimes, MD, is a board-certified pediatric emergency medicine physician with over 20 years of clinical experience. She received her medical degree from Baylor College of Medicine and completed her residency and fellowship training at Texas Children’s Hospital.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Farzon A. Nahvi, MD

Dr. Nahvi is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works clinically at Concord Hospital in Concord, New Hampshire, and is a clinical assistant professor of emergency medicine at the Geisel School of Medicine at Dartmouth. Prior to this, he worked as an ER physician and clinical assistant professor of emergency medicine at the Mount Sinai Health System, NYU Langone Health, NYC Health + Hospitals/Bellevue, and the Manhattan VA. He is a graduate of Cornell University and NYU School of Medicine.

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