Please note that this information does not qualify you as an official first aider, and Virtual College advises calling 999 in the first instance at the scene of an emergency.
This material and any associated assessments do not constitute a qualification or accreditation as an official first aider. All content provided is for general information only.
Virtual College advocates dialling the emergency services before attempting any form of first aid.
Although the majority of people will go through their lives never experiencing an epileptic seizure, they can happen to anyone and are triggered by a range of different things. It can be alarming to witness someone having a seizure if you’re not prepared for it, but the steps you need to take to keep them safe are relatively simple.
First aid for seizures is something that every first aider should know, and can also be useful information for anyone to have in case they encounter someone having a seizure. In this article, we’re going to go through exactly what happens when an epileptic fit occurs, how you can recognise a seizure happening, what you should do to help the person, and when you should call an ambulance.
Epileptic seizures and epilepsy should not be confused, though they can be related. The phrase ‘epileptic seizure’ refers to the seizure event itself, but those people with epilepsy have a condition whereby they are susceptible to seizures that begin in the brain.
A person can suffer from an epileptic seizure (also known as an epileptic fit) when they experience abnormal electrical activity in the brain. This can be a serious medical condition, and any member of the population could potentially experience an epileptic seizure at some point in their lives.
There are many potential triggers for an epileptic seizure, and it is unfortunately not always possible to be sure exactly why one has occurred. However, there are numerous described causes, and they tend to be more or less likely based on the person’s age.
Some of the major triggers include the following:
Contrary to popular belief, epileptic seizures triggered by light activity (such as strobe lighting) are very uncommon and generally account for only a very small fraction of incidents.
Epileptic seizures happen when there is excessive or abnormal behaviour in neural activity occurring in any part of the brain. These can affect normal brain function, causing everything from auditory hallucinations and visual disturbances to severe physical reactions.
Seizures can be one-off events, or commonplace symptoms of a particular condition, and can range from being minor to the point that no medical attention is required, to needing lifelong management.
There is more than one type of seizure to be aware of. A tonic-clonic, or convulsive seizure (previously known as a grand mal seizure), is the most commonly encountered and recognised and will involve a period of muscle contractions and stiffness, followed by shaking or convulsions. There are numerous other potential symptoms however, which can include loss of consciousness, confusion, auditory and visual hallucinations and more.
It helps to be able to understand all of the potential symptoms and types of seizures to be able to recognise one occurring. Understanding what is happening to someone makes it easier to respond faster, limiting any potential harm.
There are actually two types of seizures that can occur as a result of this abnormal brain activity. They are focal and generalised seizures, and it’s important to know the difference because they manifest themselves differently and can have different treatment paths.
Focal seizures, as their name suggests, begin in one part of the brain, which means that their effects can be varied depending on which part of the brain has been affected. They can be fairly minor events in which the person remains conscious and remembers the seizure, having experienced phenomena such as hallucinatory lights and smells.
In other instances, the person becomes confused or unconscious and may engage in strange movements known as automatisms. Focal seizures can sometimes progress to become generalised seizures.
Generalised seizures however affect the entire brain, and will usually result in a period of unconsciousness that the person does not remember. During this, there are a variety of things that can happen:
Seizures can be one of the most visually concerning medical situations that a first aider might come across, ranging from being severe to fairly mild.
First aid for seizures generally means making the situation safe rather than directly treating the person. There are several things that you can do, and several things you shouldn’t do, in order to make the situation as safe as possible for the person experiencing the seizure.
If a person is having a focal seizure, whereby they do not lose consciousness or suffer from full-body convulsions or muscle relaxation, then your primary aim is to guide them away from any danger. Try and keep them aware of what’s going on, as confusion is a very common symptom.
There are some additional steps you should take once the seizure has subsided to help the person recover. They include the following:
While seizures can be commonplace for certain medical conditions, there are many situations in which it is appropriate to call for emergency medical help. They include the following:
A tonic-clonic seizure is a medical term for what most people think of as a typical seizure. It involves a ‘tonic’ and a ‘clonic’ stage, where the person affected initially falls unconscious and goes stiff when their muscles tense, then experiences convulsions until the seizure finishes.
This type of seizure was previously known as a ‘grand mal’, which is French for ‘great illness’.
The duration of a seizure drastically varies between incidents, but the majority of them last between thirty seconds and two minutes. If a seizure lasts for longer than five minutes, or someone that usually has short seizures has them for a longer period of time, it’s recommended that you call an ambulance as longer seizures present a risk of brain damage.
The recovery time needed after a seizure varies from person to person, and also often depends on how long the seizure lasted and whether they were injured during it. Some people will feel better after several hours, but many people find that it takes them several days to recover fully from having an epileptic seizure.
Epileptic seizures can range from short absences to extended periods of unconsciousness, potentially resulting in hospitalisation. As a first aider, the most important thing you can do in the event of a seizure is to stay calm and keep the person safe from harm, keeping track of their symptoms and understanding when professional medical help is required.
You may find our course on the Primary Survey a useful addition to the information in this article, as it covers how you and other employees in the workplace approach first aid situations, like an epileptic fit, in the proper way.
If you’d like to learn more about first aid for epilepsy, our ‘Epilepsy Assessment’ online training course was created in partnership with ESNA to share the latest guidelines on administering buccal midazolam to people with epilepsy.