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Stay, protect, time, and observe. Keep the person safe from hazards, ease them to the floor if they are falling, cushion their head, turn them on their side when they are lying down, and watch the clock. Do not restrain them or put anything in their mouth. Most seizures end without an ambulance, but a seizure lasting more than five minutes, repeated seizures, breathing or waking problems, injury, water involvement, a first seizure, pregnancy, or diabetes with loss of consciousness requires 911 in the United States.
The sequence below follows current public guidance from the Centers for Disease Control and Prevention (CDC), updated May 15, 2024. It is general first aid, not a substitute for an individual seizure action plan or professional medical advice.
What a seizure can look like
A seizure is a burst of abnormal electrical activity in the brain. It may be dramatic, with a fall, stiffening and rhythmic jerking, but it can also be quiet. The CDC describes focal seizures as beginning on one side of the brain and potentially changing awareness, behavior, sensation or movement. Generalized seizures begin, or appear to begin, on both sides. A generalized tonic-clonic seizure can cause loss of consciousness, stiffness, jerking, confusion and marked tiredness afterward. Other seizures may look like staring, wandering, unusual movements, brief lapses in awareness or an inability to answer.
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About one in 10 people in the United States may have a seizure during their lifetime, according to a CDC page citing epidemiological research. That statistic is population context, not a prediction about any individual.
The immediate sequence: stay, protect, time, position
1. Stay with the person and keep calm
Remain nearby from the beginning of the event through recovery. Ask others to stay calm and give the person space. A calm helper can notice changes, prevent avoidable injuries and provide an accurate duration and description to emergency responders or clinicians.
2. Protect against nearby hazards
Move hard, sharp or hot objects out of reach. Clear bags, furniture, sports equipment, tools, glass and loose cords from the surrounding area. If the person appears to be falling, ease them to the ground rather than trying to catch or hold them upright. Do not move them farther than necessary unless the location itself is dangerous.
For a generalized seizure, place something soft and flat, such as a folded jacket, under the head. Remove glasses and loosen restrictive clothing around the neck. These steps reduce impact and leave the airway area less constricted without interfering with the person’s movements.
3. Look for medical information
When it is safe to do so, check for a medical identification bracelet. It may list a condition, medicines or emergency contacts. Do not delay urgent care to search for identification, and do not administer a medicine based only on a label unless you are following a documented plan and are trained and authorized to do so.
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4. Time the event
Use a phone, watch or clock and note when observable seizure activity starts and stops. A duration that feels brief can be difficult to estimate accurately. Record whether another seizure begins soon after, whether the person was injured, and whether the event occurred in water. These details determine whether emergency help is needed and help a clinician understand what happened.
5. Turn a person who is lying down onto one side
If the person is on the floor or otherwise lying down, gently turn them onto one side with the mouth angled toward the ground. This position helps secretions drain and keeps the airway clearer. Do not force the position if doing so would put you or the person at risk; wait for a safe moment and avoid pressing on the chest or abdomen.
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- Do not restrain the person. Holding limbs down or trying to stop the movements can injure both the person and the helper.
- Do not put anything in the mouth. Objects, fingers and makeshift “bite blocks” can damage teeth or the jaw and may become choking hazards. A person cannot swallow their tongue.
- Do not give food, water or pills. Wait until the person is fully alert and able to swallow normally; giving anything sooner can cause choking.
- Do not give mouth-to-mouth breaths while the seizure is happening. The CDC says people usually begin breathing again on their own after the seizure ends. Focus on clearing hazards, timing and observing breathing rather than placing anything in the mouth.
- Do not crowd, shout at or shake the person. Extra stimulation can make the scene more frightening and does not stop the seizure. Ask onlookers to step back.
These restrictions apply even when the movements look forceful. Your role is to prevent secondary injury and recognize an emergency, not to stop the brain activity by force.
When to call 911 in the United States
Call 911 if any CDC emergency criterion applies. Tell the dispatcher that the person is having, or has just had, a seizure and give the measured duration and relevant circumstances.
- The seizure lasts longer than five minutes.
- Another seizure starts soon after the first, especially when the person does not return to normal awareness between events.
- The person has trouble breathing or has difficulty waking after the seizure.
- The person is injured.
- The seizure happens in water.
- It is the person’s first known seizure.
- The person has diabetes and lost consciousness.
- The person is pregnant.
Back-to-back seizures within a five-minute period can increase the risk of brain injury or death. The CDC identifies this prolonged or repeated state, called status epilepticus, as a medical emergency; see its Health and Safety Concerns guidance.
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These are U.S. public-health instructions. If you are elsewhere, use your country’s emergency number and local dispatcher instructions. Do not drive the person yourself when an ambulance is indicated unless emergency services specifically direct you to do so.
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CDC public guidance says seizures do not usually require emergency medical attention. If a person with a known seizure disorder has a brief event, is not injured, resumes normal breathing and begins recovering as expected, stay with them and provide quiet assistance rather than automatically calling 911. Follow any seizure action plan the person has made with their clinician.
“Brief” is not a substitute for timing. A seizure that approaches five minutes, repeats, or leaves the person unable to breathe or wake crosses the emergency threshold. When uncertain about the duration, recovery or safety of the setting, call 911 and describe what you see.
After the movements stop: recovery care
Check breathing and responsiveness
Watch the person as the seizure ends. Confusion, sleepiness and fatigue can occur, but breathing should resume and awareness should gradually improve. If they have trouble breathing or waking, call 911. Keep monitoring while help is on the way and follow dispatcher instructions.
Provide a safe place to recover
When the person is able, help them sit somewhere safe to recover. Keep them away from traffic, stairs, water, hot surfaces and sharp edges. Speak softly and use short, reassuring sentences; confusion can make questions and explanations difficult at first.
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Explain and offer practical help
Once they are alert, explain that they had a seizure and what you observed, including the approximate duration. Offer to contact a friend or loved one and help arrange a safe way home. Do not pressure them to stand, walk or eat until they are steady and fully alert.
Document useful observations
Write down the start and end times, movements, changes in awareness, breathing, injuries, possible water exposure and how long recovery took. If a medical bracelet lists a clinician or emergency contact, use it when appropriate. A clear account can be more useful than a guess about the seizure’s type or cause.
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Seizure in water
Water involvement is an emergency criterion. Call 911. Prioritize getting the person out of the water only if you can do so without endangering yourself, then assess breathing and follow dispatcher directions. Do not delay the call while trying to determine how long the person was submerged.
Fall or other injury
Do not move the person unnecessarily if you suspect a serious head, neck or back injury. Clear hazards around them, protect the head, and call 911 when an injury occurred or is suspected. Tell responders what struck the person and whether they lost consciousness.
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First known seizure
A first seizure warrants 911 under CDC guidance, even if the movements stop quickly. Stay with the person, time the event, protect them from hazards and provide responders with the observation record.
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Pregnancy or diabetes
Call 911 when the person is pregnant or has diabetes with loss of consciousness. Do not give food, drink or medication by mouth while the person is confused or not fully alert. Tell dispatchers about the pregnancy or diabetes if you know it.
Public places, schools and sports settings
Assign one person to stay with the individual, another to clear the area and another to call 911 when criteria are met. Keep bystanders back, preserve privacy and ask staff to manage traffic or access. The CDC notes that free, online, on-demand seizure first-aid training is available through the Epilepsy Foundation and can be useful for family members, coaches, group leaders and school or public-setting workers.
Common mistakes and how to correct them
| Situation | Safer response |
|---|---|
| Someone reaches for a spoon or another object to “protect” the tongue | Remove objects from the area, but put nothing in the person’s mouth. |
| A helper pins down jerking arms or legs | Release the person and clear the surrounding space; restraint can cause injury. |
| Water or medicine is offered immediately after the shaking stops | Wait for full alertness and normal swallowing. |
| The event is judged by eye without a clock | Start timing as soon as you notice it and record repeated episodes separately. |
| Several people surround or question the person | Ask onlookers to step back and keep one calm communicator nearby. |
| A known epilepsy diagnosis is treated as proof that no help is needed | Use the emergency criteria: duration, recurrence, breathing or waking difficulty, injury, water, first seizure, pregnancy and diabetes with loss of consciousness. |
Limits of general first-aid advice
General guidance cannot tell you the cause of an individual seizure or replace a clinician’s instructions. Some people have a written seizure action plan that specifies when and how a trained caregiver may use prescribed rescue medication. This article does not create such a plan or provide individualized dosing instructions. If you care for someone with recurrent seizures, ask their clinician what the plan says, who is authorized to act, and when emergency services should be called.
Emergency numbers, dispatcher procedures and access to training vary by country. The thresholds above are the CDC’s U.S. public guidance, current May 15, 2024. For local practice, use your emergency service and a qualified health professional.
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