A Parent’s Guide to Seizure First Aid: 3 Steps to Take

A seizure is an episode of abnormal electrical activity in the brain that triggers changes in mental awareness, muscle control, and autonomic function — and sometimes, changes in behavior, emotions, and senses, too.  

If our team at THINK Neurology for Kids has diagnosed your child with a seizure disorder or epilepsy, our comprehensive management plan includes teaching you “seizure first aid,” or how to respond and keep your child safe at the onset of a seizure episode. 

Understanding seizures 

A seizure occurs when specialized brain cells (neurons) in the brain’s electrical network malfunction and fire uncontrollably. As the brain’s electrical activity goes haywire, it may trigger:

• A temporary loss of consciousness
• Muscle spasms or convulsions
• Back, leg, and arm stiffening
• Paused activity; staring into space
• Sudden confusion, fear, or joy
• Teeth clenching and drooling  
• Rapid, repetitive eye blinking
• Loss of bladder or bowel control

The many different seizure types fall into two basic categories: generalized onset and focal onset seizures. A child who has generalized tonic-clonic seizures, for example, may cry out, lose consciousness, fall to the floor, stiffen through their back and limbs, and convulse in jerking movements. 

A child who has a generalized absence seizure, on the other hand, simply stops what they’re doing and stares blankly. A child experiencing a focal seizure may experience a dreamlike change in consciousness; they may also display typical, repetitive behaviors, such as rapid eye blinking or walking in circles.

Seizure first aid response

Providing the right care in the moment can protect your child from harm during a seizure, and help them feel reassured and calm as they regain normal consciousness and recover. Just remember the three “S steps”: stay, safe, side.   

1. STAY with your child  

Stay with your child and remain calm. Use a clock, wristwatch, or your smartphone to time the seizure from its onset to its end.

While most episodes last 1-3 minutes, seizures can also be unpredictable. Some may end in mere seconds, whereas others persist beyond the three-minute mark. Timing the seizure can help you determine when emergency help is necessary — generally starting at the five-minute mark. 

2. Keep your child SAFE 

Gently guide your child to the floor if they’re upright (standing or sitting). Clear the area of potentially hazardous objects, such as sharp-edged tables or hard toys. Place a soft, flat object, such as a folded towel or shirt, under their head to cushion it. Loosen tight clothing at the neck. 

Do not restrain your convulsing child, and don’t put anything into their mouth; even if they inadvertently bite their tongue during convulsions, they won’t swallow their tongue.

During the tonic phase of a seizure, your child’s chest muscles may tighten to the point that it appears as though they’ve stopped breathing. Don’t start rescue breathing; as this part of the seizure ends, their chest muscles will relax, and normal respiration will resume. 

If your child’s seizure causes a change in consciousness that makes them wander or feel confused, guide them away from danger (i.e., street traffic, stairs, sharp objects). Whether they’re awake or unconscious, direct others to step back and give your child space.  

3. Turn them on their SIDE

If your child isn’t yet awake and alert when the convulsions stop, gently roll them onto their side. This “recovery position” keeps their airway open so they can breathe easier and expel excess saliva and spontaneous vomit.    

Seizures can be frightening for your child. Speak to them calmly as they wake, and reassure them that they’re safe. Be sensitive and supportive if they feel embarrassed around others. 

Emergency seizure care 

It’s important to seek emergency medical care the first time your child has a seizure. But once your child has been diagnosed with a seizure disorder, their treatment plan can help you manage most of their seizures safely on your own.  

However, you should seek immediate medical care if:

• Your child’s seizure lasts longer than five minutes
• They have multiple seizures in a row (cluster seizures)
• Your child has diabetes, is sick, or has a high fever
• The seizure started in water (i.e., a pool or the bathtub)
• They may have injured their head during the seizure
• Your child has trouble breathing after the seizure
• They don’t seem like their usual self after the seizure
• Your child asks for medical help after their seizure

To learn more about seizure first aid, schedule an appointment today at THINK Neurology for Kids in The Woodlands, Katy, Sugar Land, or San Antonio, Texas. 

Our team — including Shaun Varghese, MD, Cristina Marchesano, MD, Lorena Herbert, MD, Barbara Kiersz-Mueller, DO, Lauren Weaver, MD, Alicia Walls, MD, Sundeep Mandava, MD, Sherwin Oommen, MD, Robby Korah, FNP-C, Jennifer Duchaney, CPNP-PC, Tammy DeLaGarza, FNP-C, and Heather King, CPNP-PC — is always here to help.