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Stay with the person, start timing, protect them from injury, and keep their airway as clear as you safely can. Move hazards away, cushion their head, remove glasses, loosen tight neckwear, and turn them onto their side when possible. Do not restrain them or put anything in their mouth. Call 911 if the seizure lasts more than five minutes, repeats, causes injury or breathing problems, occurs in water, or meets the other emergency conditions below.
What to do immediately
A seizure can be frightening, but calm, practical action prevents many injuries. You do not need to identify the seizure type to provide first aid. Focus on timing, safety, breathing, and what happens afterward.
- Stay and start timing. Note the time the event begins, or start a timer as soon as you notice it. Ask other people to remain calm and give the person space. The exact duration matters when deciding whether emergency help is needed.
- Make the area safer. Move furniture, sharp objects, hot drinks, tools, and other hazards away. If the person is beginning to fall and you can do so without putting yourself at risk, ease them to the floor rather than trying to catch or carry them.
- Protect the head. Place something soft and flat, such as a folded jacket, under the head. Remove eyeglasses. Loosen a tie, scarf, collar, or other tight clothing around the neck.
- Use a side position when safe. If the person is lying down, gently roll them onto their side with the mouth angled toward the ground. This recovery position can help secretions drain and makes breathing easier. Do not force the position while strong movements make it unsafe; wait for a safer moment.
- Observe breathing and behavior. Watch the chest and face, note changes in color or responsiveness, and look for injury. Do not put your fingers in the mouth. Check for a medical-identification bracelet or other identification when you can do so without delaying urgent care.
- Follow an existing plan only within your role. If the person has a seizure action plan or prescribed rescue medicine, follow the written instructions. Assist with medicine only if you are trained, authorized, and instructed to do so. Never improvise a dose or give someone else’s medication.
These steps reflect guidance from the Centers for Disease Control and Prevention (CDC) and the Epilepsy Foundation. The American Red Cross also recommends appropriate recovery positioning and says to begin CPR according to your training and use an automated external defibrillator (AED) if the person is unresponsive and not breathing after the seizure.
What a seizure may look like
Seizures vary widely. The familiar image of a person falling and shaking is only one presentation and may not be the most common one. A person may remain upright, stare blankly, stop responding, make repetitive movements, wander, appear confused, or report unusual sensations. Some seizures involve stiffening, rhythmic jerking, a sudden loss of awareness, or a fall.
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Focal and generalized patterns
CDC describes focal seizures as beginning on one side of the brain. They can produce a localized movement, altered sensation, unusual emotion, staring, or impaired awareness. Generalized seizures begin, or appear to begin, on both sides of the brain and may affect awareness and movement more broadly. A bystander should not attempt to diagnose the type during an event; the safety steps are the same.
When someone wanders or seems confused
Some people become confused or walk without responding normally. Do not grab, argue with, or physically restrain them unless immediate danger makes a gentle safety intervention unavoidable. Walk beside them, guide them away from traffic, stairs, water, or other hazards, and speak in a calm voice. Keep timing the event and call 911 if any emergency criterion applies.
What not to do
- Do not hold the person down. Restraining the movements can cause muscle, joint, or other injuries. Clear the surroundings instead.
- Do not put anything in the mouth. Fingers, spoons, keys, cloth, and other objects can break teeth, block breathing, or injure the mouth. A person cannot swallow their tongue.
- Do not give food, water, pills, or other items to swallow until the person is fully awake and able to swallow normally. Giving anything during impaired awareness creates a choking risk.
- Do not give mouth-to-mouth breaths during the seizure. Reassess breathing after the movements stop. If the person is then unresponsive and not breathing normally, follow emergency CPR guidance and use an AED if available.
- Do not crowd the person or film the event. Ask onlookers to step back, protect privacy, and leave room for air and for emergency responders.
When to call 911 in the United States
CDC says seizures do not usually require emergency medical attention, but certain situations are emergencies. Call 911 when any item in this checklist applies:
| Call 911 when… | What to do while help is coming |
|---|---|
| The seizure lasts longer than five minutes. | Keep timing, protect the head, clear hazards, and follow any prescribed action plan within your training. |
| Another seizure begins soon after the first. | Do not assume the person has recovered between events. Continue safety measures and tell the dispatcher that seizures are repeating. |
| The person has trouble breathing or does not wake normally after the seizure. | Check responsiveness and breathing after movements stop. If unresponsive and not breathing normally, begin CPR according to your training and use an AED if available. |
| The person is injured. | Do not move them unnecessarily if a serious injury is possible, unless remaining there is dangerous. Tell responders what happened and where the injury occurred. |
| The seizure happens in water. | Get the person out of danger without putting yourself at risk. Call 911, even if the seizure appears to stop, because breathing problems or drowning injury may follow. |
| The person has never had a seizure before. | Stay with them, record what you observed, and provide the dispatcher with the duration and recovery details. |
| The person has diabetes and loses consciousness. | Call 911. Do not give food, drink, or glucose by mouth while they are unconscious. |
| The person is pregnant. | Call 911 and tell the dispatcher the person is pregnant. Protect them from injury and monitor breathing. |
For readers outside the United States, use your country’s emergency number. The criteria above are the CDC’s U.S.-focused guidance; local dispatchers may give additional instructions.
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How to check breathing and respond after the movements stop
If the person is breathing
Keep them on their side when practical, or place them in another safe position that allows easy breathing. Watch for normal chest movement and signs that they are waking. The person may be sleepy, confused, embarrassed, or have a headache. That recovery period can be part of the seizure’s aftermath.
If the person is unresponsive and not breathing normally
Call 911 or direct someone specific to call. Begin CPR according to your current training and use an AED if one is available. The American Red Cross specifically advises these actions after a seizure when the person is unresponsive and not breathing. Follow the dispatcher’s instructions if you are not trained or are uncertain about the steps.
If breathing is difficult but present
Call 911, keep the airway as clear as possible with a safe side position, and watch continuously. Do not give drinks, medication, or breaths into the mouth during ongoing seizure activity. Tell responders what you saw, how long it lasted, and whether breathing changed.
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Support the person during recovery
- Stay until they are awake and alert. Do not leave immediately when the movements stop. Continue observing breathing and responsiveness.
- Offer a safe place to sit or lie down. They may be weak or unsteady. Help them move only when they can participate safely.
- Reassure without overwhelming them. Say who you are and explain simply: “You had a seizure. It has stopped. You are safe.” Ask before touching or moving personal belongings.
- Protect dignity and privacy. Move onlookers away, cover exposed clothing when appropriate, and avoid discussing the event loudly.
- Offer practical help. Ask whether they want you to contact a family member, friend, caregiver, or other trusted person. Do not assume they can drive, work, climb stairs, swim, or resume normal activities immediately.
- Share useful observations. Tell the person, caregiver, or clinician when the event started, how long it lasted, what movements or behavior you observed, whether there was an injury, and how alert the person was afterward.
Wait until the person is fully alert before offering water, food, or oral medication, and only if they can swallow safely. If any emergency criterion applies, do not substitute reassurance or a known seizure history for medical evaluation.
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Information that helps emergency responders
A bystander’s observations can be more useful than a guessed diagnosis. If it is safe, remember or write down:
- The exact start and stop time, including whether one seizure followed another.
- Whether the person fell, struck their head, entered water, or sustained another injury.
- Whether they were awake, responsive, staring, wandering, stiff, jerking, or making repetitive movements.
- Changes in breathing, skin color, or responsiveness during and after the event.
- Any medical-identification information, seizure action plan, or rescue-medicine instructions you saw.
- What the person was doing immediately before the event and how long recovery took.
Do not delay a 911 call to collect every detail. Safety and breathing come first; observations can be supplied afterward.
Common situations that need extra care
A seizure in a crowded public place
Ask one person to create space and another to call 911 if a criterion is present. Keep bags, phones, and curious bystanders away from the person. Assign tasks clearly rather than allowing everyone to act at once.
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Move hazards away if possible. Do not drag or carry the person through active movements unless leaving them in place presents a greater immediate danger. Once the seizure stops, move them to a safer area if they can be moved without worsening a suspected injury.
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A seizure in water
Prioritize your own safety while getting the person out of the water, call 911, and monitor breathing. Water exposure is one of the CDC’s emergency criteria even if the person appears to recover quickly.
A person who has a known seizure disorder
A known history does not automatically mean an ambulance is unnecessary, and it does not mean every event requires one. Use the person’s action plan if available, time the event, and apply the CDC emergency criteria. A seizure lasting more than five minutes, repeated seizures, breathing trouble, injury, pregnancy, diabetes with loss of consciousness, or another listed condition still requires 911.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Preparing before a seizure happens
People who live with epilepsy, their families, caregivers, coaches, teachers, group leaders, and public-facing staff can prepare in advance. CDC identifies these groups as audiences who may benefit from detailed training.
Learn a written action plan
Ask the person or their clinician what their seizures usually look like, how long they typically last, when rescue medicine is prescribed, and which signs require emergency help. Keep the plan where caregivers can find it, while respecting the person’s privacy.
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Take first-aid training
The CDC points to free, online, on-demand seizure first-aid training through the Epilepsy Foundation. Training can help caregivers, school staff, coaches, and other responders practice timing, positioning, emergency decisions, and post-seizure support. Training complements—not replaces—the person’s medical plan and emergency services.
Post clear reminders
The Epilepsy Foundation publishes an English seizure first-aid poster; its listing identifies a July 2024 revision. A poster can remind staff and visitors to stay, make the area safe, time the seizure, protect the head, place the person on their side when appropriate, and avoid restraint or objects in the mouth. Confirm that any printed material matches current guidance and local emergency procedures.
Plan for public settings
- Tell designated staff where the action plan and emergency contacts are kept.
- Know how to access a phone, first-aid kit, CPR equipment, and an AED.
- Agree in advance who calls 911, who meets responders, and who stays with the person.
- Use medical identification when the person chooses to wear it.
Why recognizing different presentations matters
Assuming that every seizure means falling and shaking can make a witness miss a less dramatic event. Staring, sudden confusion, wandering, altered sensations, or unusual movements may still reflect a seizure and may leave the person unable to respond safely. The correct response is not to label the event on the spot; it is to protect the person, time what happens, monitor breathing, and seek emergency help when the criteria apply.
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After the event: when medical follow-up matters
Call 911 for the emergency situations listed above. Even when an ambulance is not required, the person may need advice from their clinician, especially after a first suspected seizure, a change from their usual pattern, an injury, prolonged confusion, or repeated events. Share your observations rather than asserting a diagnosis.
If the person is not fully recovered, has worsening breathing, or becomes difficult to wake, treat that as an emergency. Continue monitoring while waiting for professional help and follow dispatcher instructions.
Quick Recap
Sources for this guidance
- Centers for Disease Control and Prevention, “First Aid for Seizures,” published and updated May 15, 2024; reviewed February 8, 2024.
- Epilepsy Foundation, “First Aid for Seizures | Stay, Safe, Side,” accessed October 11, 2026.
- Epilepsy Foundation, “Seizure First Aid Poster (English),” listing accessed October 11, 2026; poster filename indicates a July 2024 revision.
- American Red Cross, “Seizures: Causes, Symptoms, and Types,” accessed October 11, 2026.
- Centers for Disease Control and Prevention, “Types of Seizures,” published and updated May 15, 2024; reviewed January 10, 2024.
- Centers for Disease Control and Prevention, “Epilepsy Basics,” accessed October 11, 2026.
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