Ethan Rhodes
Seizures are a common condition of the brain, often associated with epilepsy, that can vary in frequency and type. While people with epilepsy do not always need to go to the hospital after experiencing a seizure, there are several important steps to take when providing first aid for a seizure. This includes loosening any tight clothing around the neck, turning the person onto their side, and timing the seizure—if it lasts longer than 5 minutes, seek immediate medical attention. In addition to these emergency measures, there are several treatment methods for seizures, including medication, surgery, and alternative therapies such as the keto diet, herbal remedies, and cannabis-based treatments.
How to treat a seizure in a hospital
| Characteristics | Values |
|---|---|
| If the person is lying down | Turn them gently on their side, with their mouth pointing to the ground to keep their airway clear |
| Time the seizure | Track if it lasts more than 5 minutes. If it does, seek immediate medical attention or call 911 |
| After the seizure | Help them sit in a safe place to recover. Offer to call a friend or loved one to help them get home safely |
| Restrain the person | Do not hold the person down or restrain them. Do not place anything in their mouth or try to pry their teeth apart |
| Loosen neckwear | Loosen anything around the neck that could block breathing |
| Medication | Anticonvulsant medication can be taken regularly to prevent seizures. People with epilepsy usually have a care plan agreed with doctors that includes giving emergency medicine |
| Surgery | Surgery may be an option for some people |
| Diet | Research suggests that a diet can reduce the frequency of seizures in some people with epilepsy. However, the diet is very restrictive and most people find it difficult to follow |
| Herbal remedies | Some people use herbal remedies to treat epilepsy, but there is no evidence of their effectiveness |
| Nutritional deficiencies | People with epilepsy may have lower levels of certain nutrients such as folic acid, vitamin D, or calcium. Doctors may prescribe supplements to treat these deficiencies |
| Cannabis | Some people use cannabis products to help treat convulsions. The FDA has approved Epidiolex, a drug containing a cannabis-based ingredient, to treat seizures that stem from two rare and severe genetic conditions |
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What You'll Learn
Ensure the person's airway is clear by turning them on their side
When a person is having a seizure, it is important to ensure their safety and prevent injury. One crucial step is to ensure the person's airway is clear by turning them onto their side. Here are some detailed instructions on how to do this effectively and safely:
Firstly, if the person is lying down, gently turn them onto their side. This position helps keep their airway clear and facilitates easier breathing. Ensure their mouth is pointing towards the ground to prevent saliva from blocking their airway. It is also recommended to put something soft and flat, like a jacket, under their head for support.
Clearing the space around the person is essential to prevent any potential injuries. Remove any objects or hazards nearby. If they are wearing eyeglasses, take them off and place them somewhere safe. Additionally, loosen anything around their neck, such as a scarf or tight clothing, to ensure unobstructed breathing.
While the seizure is ongoing, time it to track its duration. If it lasts more than five minutes, seek immediate medical attention by calling for emergency services. It is important to note that you should not hold the person down or try to restrain them as this could cause injury to both of you.
After the seizure has ended, help the person sit in a safe place to recover. Offer comfort and reassurance, and explain what happened once they are alert and able to communicate. You may also offer to call a friend or loved one to stay with them or help them get home safely.
It is important to remain calm and talk calmly to the person during and after the seizure. Check for any medical ID or rescue medicines prescribed by a healthcare professional. Remember, most seizures only last a few minutes, but they can be unpredictable, so it is crucial to be prepared and know how to respond effectively.
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Time the seizure and seek medical attention if it lasts over 5 minutes
Timing a seizure is crucial to determine whether further medical attention is required. Seizures typically last from a few seconds to a few minutes. If a seizure lasts for over five minutes, it is classified as a prolonged seizure, and immediate medical attention is necessary.
During a seizure, the person experiencing it has no control over their body, and their safety is paramount. If they are lying down, gently turn them onto their side with their mouth pointing downwards to ensure their airway remains clear. Loosen any tight clothing around their neck to facilitate breathing. Do not hold the person down or attempt to restrict their movements, as this can cause injury to both of you.
If the seizure lasts for over five minutes, call for emergency medical services or seek immediate medical attention. This prolonged seizure duration is considered a medical emergency. While waiting for medical assistance, continue to time the seizure and monitor the person's breathing and vital signs. Ensure they remain in a safe position and are protected from any potential harm.
After the seizure, help the person sit in a safe place to recover. Offer comfort and explain what happened once they become alert. You may also offer to contact a friend or loved one to help them get home safely. It is important to recognize the signs of a seizure to provide appropriate assistance. Seizures can cause a person to fall, shake, twitch, or become unaware of their surroundings.
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Cushion the person's head and loosen tight neckwear
Cushioning a person's head and loosening tight neckwear are crucial steps in treating a person experiencing a seizure. Here are some detailed instructions on how to perform these steps effectively:
Cushion the Person's Head:
- If the person is in a wheelchair, try to gently support them by keeping them in the wheelchair to avoid any potential injury from falling. You can use a rolled-up jumper or a headrest to cushion their head.
- If the person is not in a wheelchair, place a soft object such as a jacket, pillow, or blanket under their head to protect it from injury.
- Remove any glasses or other objects that might cause harm to the person's face or head during the seizure.
- Ensure that the person's head remains in a safe position, especially if they are near water. Keep their head above water level, and gently tilt their head to keep their face out of the water.
Loosen Tight Neckwear:
- Loosen any tight clothing, scarves, ties, or jewellery around the person's neck to ensure their airway remains clear and unobstructed.
- Ensure that hair is also pulled back or loosened to prevent it from blocking the person's airway.
- If the person is wearing a helmet or other headgear, remove it carefully, ensuring that you do not move their head abruptly or restrict their airway.
These steps are essential in ensuring the person's safety and comfort during a seizure. It is important to remain calm and provide support throughout the episode.
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Administer medication to stop a severe seizure
Administering medication to stop a severe seizure is a crucial aspect of seizure management. While most seizures self-terminate within a few minutes and may not require rapid treatment with medication, certain situations call for the administration of anti-seizure medications to halt seizure activity.
Benzodiazepines
Benzodiazepines are a group of medications commonly used to stop seizures. They act rapidly by entering the bloodstream and quickly reaching the brain. Various forms of benzodiazepines are available, including oral, nasal, rectal, and injectable (intravenous or intramuscular) formulations. Examples of benzodiazepines used as rescue medications include diazepam, lorazepam, clonazepam, clorazepate, and midazolam. The specific dosage and administration guidelines may vary, and healthcare professionals should be consulted to determine the appropriate treatment plan.
Anticonvulsant Medications
If a seizure persists despite the administration of benzodiazepines, further intervention with anticonvulsant medications may be necessary. Phenytoin and sodium valproate are examples of second-line anticonvulsants that have been shown to be effective. It is important to carefully follow dosage guidelines, as some of these medications carry risks of side effects such as bradycardia and hypotension.
Individualized Treatment Plans
It is essential to recognize that seizure treatment is highly individualized. Each person's seizures are unique, and their treatment plan should be tailored accordingly. When creating a seizure action plan, it is crucial to understand the typical pattern of seizures and identify when seizures deviate from this norm. This information helps determine when rescue medications are appropriate and how often they can be administered. Training on how to administer rescue medications is also important, and caregivers should be involved in this process whenever possible.
Alternative and Complementary Treatments
In addition to conventional anti-seizure medications, some individuals may explore alternative or complementary treatments. For example, some people use cannabis or cannabidiol (CBD) products to help manage their seizures. However, larger scientific studies have not conclusively demonstrated the effectiveness of cannabis or CBD in treating epilepsy, and there are potential side effects and legal considerations to keep in mind. Additionally, certain nutritional deficiencies have been linked to seizures, and addressing these deficiencies through supplementation may be beneficial in conjunction with other treatments.
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Help the person recover by sitting them in a safe place
When a seizure is over, help the person recover by sitting them in a safe place. The person may be very disoriented, so it is important to comfort them and explain what happened. Offer to call a friend or loved one to help them get home safely. It is also important to recognise the signs of a seizure so that you can help. When a person has a generalized seizure, they may fall down if they lose muscle tone or consciousness, shake or jerk, twitch in the body or eyelids, or become unaware of their surroundings. Ease them to the ground if they appear to be falling.
To help the person recover, turn them gently onto their side with their mouth pointing to the ground to keep their airway clear. Clear the space around them to prevent injury. Loosen anything around their neck that could block breathing. Cushion their head with a pillow to prevent them from hurting themselves. Do not hold the person down or restrain them. Do not place anything in their mouth or try to pry their teeth apart. The person is not in danger of swallowing their tongue.
Observe the seizure characteristics, including length, type of movements, and direction of head or eye turning. Time the seizure to track its duration. If it lasts more than 5 minutes, seek immediate medical attention or call emergency services. Additionally, seek immediate medical attention if the person has another seizure soon after the first one, has trouble breathing or waking up after the seizure, is injured during the seizure, or if the seizure occurs in water.
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Frequently asked questions
If someone has a seizure, there are several steps you should take to provide first aid:
- Loosen anything around their neck that could block their breathing.
- Cushion their head.
- Turn them gently onto their side with their mouth pointing to the ground to keep their airway clear.
- Time the seizure—if it lasts more than 5 minutes, seek immediate medical attention.
- Observe the characteristics of the seizure, such as the length, type of movements, and direction of head or eye turning.
- After the seizure, help the person sit in a safe place to recover.
- Once they are alert, comfort them and explain what happened.
The treatment for seizures typically involves medication, such as anticonvulsants or antiepileptic drugs. However, some people may not respond well to these medications or experience side effects. In such cases, other treatment options may be considered, including:
- Surgery
- Alternative therapies, such as the keto diet, herbal remedies, or cannabis products (although larger scientific studies have not shown these to be effective)
- Nutritional supplements, as some deficiencies have been linked to seizures (e.g., low magnesium levels)
People with epilepsy do not always need to go to the hospital every time they have a seizure. They usually have a care plan agreed upon with their doctors and caregivers that outlines the steps to take during a seizure, such as giving emergency medicine. However, seek immediate medical attention or go to the hospital if:
- The seizure lasts longer than 5 minutes.
- They have another seizure soon after the first one.
- They have difficulty breathing or waking up after the seizure.
- They are injured during the seizure.
- The seizure occurs in water.
