Seizure First Aid: Stay, Safe, Side

Most seizures end on their own. Your job is to stay, keep the person safe, and turn them on their side if they are not awake.

Important: This article is educational and is not medical advice. It does not diagnose, treat, prevent, or cure any condition. Komori is not a medical device, is not FDA-cleared, does not detect seizures, and is not intended for people with epilepsy. Talk with a neurologist or epileptologist about personal medical decisions. Households living with epilepsy should use clinically validated seizure-detection devices as directed by their care team.

Why first aid is worth learning

CDC says about 1 in 10 people in the United States may have a seizure in their lifetime. You may never need these steps. If you do, they are simple.

Seizures do not all look the same. Some people fall and shake. Some stare. Some wander or pick at their clothes. The first-aid goal is the same across types: protect the person from injury, protect the airway if they are unconscious, time the event, and know when to call 911.

The Epilepsy Foundation summarizes the public steps as Stay, Safe, Side. CDC's page matches that sequence in more words. Neither one asks you to stop the seizure with your hands.

Stay

Stay with the person until they are fully alert.

Keep yourself and other people calm. Time the seizure from the start, especially the stiffening and shaking if those are present. A phone timer is better than a guess. CDC uses 5 minutes as the mark for seeking emergency care.

Check for a medical ID bracelet or necklace after you have made the space safe. It may list a diagnosis, medicines, or an emergency contact.

When the seizure is over, help the person sit in a safe place. Once they are alert, explain what happened in plain language. Offer to call someone who can get them home.

Do not leave because they say they are fine if they still look confused. Recovery can lag behind speech.

Safe

Clear hard or sharp objects. Ease the person to the ground if they are falling. Put something soft and flat under the head, such as a folded jacket. Take off eyeglasses. Loosen anything tight around the neck.

Do not hold the person down. Do not try to stop the jerking. Restraint can injure them or you.

Do not put anything in the mouth. Not a spoon, not a wallet, not your fingers. CDC is explicit: that can break teeth or the jaw. A person cannot swallow their tongue during a seizure.

Do not give mouth-to-mouth breaths while the seizure is happening. Chest muscles can tighten during the tonic phase and breathing can look absent. CDC says people usually start breathing again on their own after the seizure. Rescue breathing is generally not needed for that change.

Do not offer food, water, or pills until the person is fully alert. They can choke.

If the person is walking or looking dazed, guide them away from stairs, traffic, a hot stove, or water. Stay between them and the hazard. You do not need to restrain them if they can be steered.

Side

If the person is lying down and not awake and aware, turn them gently onto one side with the mouth pointing toward the ground. That lets saliva drain and helps keep the airway clear.

For a generalized convulsive seizure, CDC lists the extra steps in order: ease them down, turn them on the side, clear the space, cushion the head, remove glasses, loosen the neck, and time the event.

The Epilepsy Foundation notes that during a convulsion it may look as if breathing has stopped when the chest tightens. As that phase ends, muscles relax and breathing typically resumes. Turning the person on their side is the airway step you can do without medical training.

When to call 911

CDC says most seizures do not need emergency medical care. Call 911 if any of these are true:

• The seizure lasts longer than 5 minutes.
• Another seizure starts soon after the first.
• The person has trouble breathing or waking up afterward.
• The person is injured.
• The seizure happens in water.
• This is the person's first seizure.
• The person has diabetes and loses consciousness.
• The person is pregnant.

NINDS defines status epilepticus as an abnormally prolonged seizure, over 5 minutes, or recurring seizures without full recovery of consciousness in between. It can be convulsive or nonconvulsive. Nonconvulsive status may look like a long stretch of confusion or reduced alertness. CDC's health and safety page also treats back-to-back seizures in a 5-minute window as a medical emergency.

Five minutes is an operational number for bystanders and clinicians, not a casual wait-and-see mark. If you are unsure how long it has been, call.

A seizure in water is an emergency even if it was brief. Get the person out safely if you can do so without putting yourself under, keep the airway clear, and call 911.

What first aid is not

First aid does not diagnose the seizure type. It does not treat epilepsy. It does not replace a seizure action plan written by a clinician for a specific person.

Some people have prescribed rescue medicine for prolonged or clustered seizures. Only use that if you have been taught to, and only as the care team directed. This article will not name drugs or doses.

Households living with epilepsy should use clinically validated seizure-detection devices as directed by their care team. A consumer monitor is not a detection device and is not a substitute for trained first aid.

Where to learn more

CDC points to free, on-demand seizure first-aid training from the Epilepsy Foundation. That course is built for families, coaches, teachers, and people who work with the public. If you live with someone who has seizures, take it, and make sure other adults in the house know Stay, Safe, Side.

FAQ

What are the three first-aid words to remember?

Stay, Safe, Side. Stay with the person and time the event. Keep the space safe and do not restrain. Turn them on their side if they are not awake and aware.

Should I put something in the person's mouth?

No. CDC says that can injure teeth or the jaw. It does not keep anyone from swallowing a tongue.

When is a seizure long enough to call 911?

Call if it lasts more than 5 minutes, if another seizure starts before full recovery, or if breathing or waking is a problem. Also call for a first seizure, injury, water, pregnancy, or diabetes with loss of consciousness.

Do staring spells need the same first aid?

They need Stay and Safe. Side is for people who are not awake and aware. For a brief absence, keep the person out of danger and stay until they are fully back. Clusters of staring or a long confused state are reasons to use the person's seizure action plan and to seek urgent care.

Can I give water or medicine right after a seizure?

Not until the person is fully alert. CDC says food and water too soon can cause choking. Rescue medicine is a separate, clinician-directed step, not a bystander improvisation.

Sources

• CDC, First Aid for Seizures: https://www.cdc.gov/epilepsy/first-aid-for-seizures/index.html
• CDC, Types of Seizures: https://www.cdc.gov/epilepsy/about/types-of-seizures.html
• CDC, Health and Safety Concerns: https://www.cdc.gov/epilepsy/health-safety-concerns/index.html
• CDC, Sudden unexpected death in epilepsy: https://www.cdc.gov/epilepsy/sudep/index.html
• NINDS, Epilepsy and Seizures: https://www.ninds.nih.gov/health-information/disorders/epilepsy-and-seizures
• Epilepsy Foundation, First Aid for Seizures (Stay, Safe, Side) (resource pointer): https://www.epilepsy.com/recognition/first-aid-resources

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