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Seizures: what to do if someone is convulsing

A seizure looks terrifying but usually stops on its own within two or three minutes. Your job is not to stop it — nothing can — but to make sure the person does not injure themselves and can breathe. Two things that kill in seizures are head injury and choking, and both are preventable.

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What to do right now

Note the time
A seizure lasting more than 5 minutes, or a second one without full recovery in between, is status epilepticus and requires urgent drugs.
Clear the space
Move furniture and sharp objects away, put something soft under the head, loosen the collar.
Never put anything in the mouth
No spoons, fingers or wallets. The tongue cannot be swallowed; teeth and fingers break.
Do not restrain
Holding limbs causes fractures and dislocations. Let the seizure run its course.
After it stops, turn on the side
Recovery position, check breathing, stay until full awareness returns — confusion for 10–30 minutes afterwards is normal.

Call an ambulance if

The first seizure ever in this person
A seizure lasting more than 5 minutes, or repeated seizures without recovery between them
Seizure in a pregnant woman, a diabetic, after a head injury or in water
Breathing does not return within a minute, lips stay blue
Injury during the seizure, especially to the head
Seizure in a child with fever — the first episode always requires assessment

What not to do

Do not put anything between the teeth
Do not hold the person down or try to "straighten" them
Do not give water or pills until full consciousness returns
Do not splash cold water or slap the face

What the crew does

Assessment of consciousness, blood sugar, blood pressure, ECG, oxygen saturation
Anticonvulsant drugs, including strong sedatives, for a prolonged seizure
Oxygen and airway support if needed
Admission after a first seizure, status epilepticus or a seizure with injury

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

Is a single seizure epilepsy?

No. A first seizure may be caused by low blood sugar, alcohol withdrawal, fever, head injury or lack of sleep. Epilepsy is diagnosed by a neurologist after examination and EEG.

How much does a call-out cost in Moscow?

Call-out 6,000 ₽ inside the MKAD or 15,000 ₽ for a specialised crew; drugs and monitoring by the price list.

Should I film the seizure?

Yes, if someone else is caring for the person. A video helps the neurologist far more than a description.