For starters, stay calm.
Thankfully, not all seizures are life-threatening or require emergency medical attention, yet witnessing a friend, coworker, or even a stranger having a seizure can be unnerving or scary. In some cases, being able to provide basic support for the patient could even be life-saving.
If you witness someone having symptoms of a seizure, here’s what to do:
1. Stay calm
“If someone’s having a seizure, [as] difficult as it is, don’t panic,” says Padmaja Kandula, MD, neurologist at Weill Cornell Medicine and NewYork-Presbyterian. “Keeping a level head is the most important thing to do.”
2. Note the seizure duration and symptoms
Try to time the seizure and take note of what symptoms you see. If the seizure lasts longer than five minutes, causes injury to the patient, causes difficulty breathing or recovering from the seizure, or leads to a second seizure shortly after the first, you should call 911.
Emergency medical services are also important if you know it’s the patient’s first seizure, or that the patient is pregnant or has a condition like diabetes or heart disease. Here are other signs a seizure requires emergency medical attention.
3. Keep the patient safe
“If they’re in an area where they may harm themselves while their movements are occurring, try to move them away from a place of harm,” says Dr. Kandula. This is especially important if you see someone having a generalized tonic-clonic, or grand mal seizure (the kind that causes falling, jerking, and loss of awareness).
Help ease them to the floor and push away hard objects to clear the space around the patient. Remove or loosen items (like scarves, ties, or necklaces) away from the person’s neck to ease breathing, and remove eyeglasses. If possible, put something soft (like a sweater) under their head.
Try to turn the patient on their side—if possible. “If they’re unable to control their saliva or their spit because they’re not awake and alert, it should at least come out the side of their mouth,” says Dr. Kandula. Turning them on their side will ease breathing and prevent them from choking on their saliva.
Finally, do not stick your hand or anything else in the patient’s mouth. “A patient can’t bite their tongue off. That’s a very common misconception,” says Dr. Kandula.
4. Stay with the patient
Someone should be with the patient at all times. The patient may recover from the seizure and be frightened, confused, or even injured, and they may need additional support before emergency medical service arrives. Once they are awake, explain what happened to them calmly and simply.
“Those are the most important things that you can do, and then afterwards, the EMS will take over,” says Dr. Kandula.