Seizure Safety Resources
A seizure is an electrical imbalance in the brain that can cause a variety of symptoms from small involuntary trembles to major uncontrolled movements, loss of body functions, and loss of consciousness. Witnessing a seizure, especially in a child, can be a frightening event. Your reaction and response can help keep the child safe and comfortable until the seizure has ended or is controlled by medical intervention.
If your child has a condition that makes them more likely to experience seizures, it is important to be prepared if a seizure occurs. In this guide you will find resources designed to help keep a child in your care safe during a seizure. The resources in this guide are not meant to replace medical advice or consultation.
What does a seizure look like?
Not all seizures are the same — there are many different types of seizures, with many different causes. Most seizures fall into one of two broad categories: focal onset or general onset seizures.
Focal onset seizures are limited (or focused) to just one part of the brain, and the symptoms of focal seizures depend on the part of the brain where the electrical disruption occurs. For example, if the part of the brain that controls movements in a person’s left arm has an electrical disruption, their left arm may twitch or move on its own. These are sometimes called partial seizures because the symptoms may go away quickly and it may take multiple episodes to realize that seizure activity has occurred. Learn more in this article from Nemours, Kid’s Health.
General onset seizures involve a disruption or change in electrical activity that affects the whole brain. The person experiencing this type of seizure may lose consciousness, have major uncontrolled movements, and lose control of body functions. This type of seizure is sometimes called a tonic-clonic seizure, and was commonly called a grand mal seizure in the past. Learn more in this article from Nemours, Kid’s Health.
There are many sub-categories of seizures. To learn more about different subtypes of seizure activity and other terms related to seizures, visit this guide from The Epilepsy Foundation.
Seizure First Aid & Safety in the Moment
If a child in your care has a seizure, or if you happen upon a person who is experiencing an absent seizure (where they are unconscious and unable to speak for themselves), the following actions can help to keep that person safe during the seizure. These recommendations come from a variety of medical resources including the Seizure First Aid guide from the Centers for Disease Control and Prevention (CDC). Stay calm, ask yourself the following questions and take the following actions if you believe you are witnessing a seizure.
Is the person in a safe position? If a person begins to seize while standing, try to get them to a safe position, lying on the ground. If they are in or near water, move them away from the water or help place their head in a position where they are unlikely to breathe in any water. Move broken glass, sharp or unsafe objects away from the person. Roll them on their side to fully open their airway. Do not hold them down or attempt to restrict their movements. Doing so could injure them, or you.
Is there anything in their mouth? If the person was eating, drinking, chewing gum, or had anything in their mouth at the time the seizure started, try to safely remove these items to prevent choking. Do not pry their jaw open, or shove anything in their mouth. Once the seizure passes do not offer food or water until they are fully alert and able to make their own decisions (a second seizure could occur, and you want their mouth to be clear if it does).
Are they wearing a medical alert accessory, carrying a phone or wallet with an identification card, or is there a person who knows them nearby? Medical treatment for a seizure depends on whether or not this is a person’s first seizure, and if they already have a diagnosed disorder that makes them more likely to have a seizure. Asking a companion or seeing a medical alert accessory may help you to know more about the person you are assisting.
How long has the seizure been going on? It is important to use a watch, timer, or other clock to record the amount of time a person spends seizing. As soon as possible, ideally right when the seizure begins, start a timer and be prepared to share this information with the person when they wake up, or with first responders.
Do they need CPR? It is very rare for a seizure to cause a person’s heart to stop, or limit their ability to breathe. It is unlikely that they will need CPR following a seizure. If you are certified in CPR perform an assessment to see if it is needed.
Should I call 911? Seizures can be frightening to witness, but not every seizure requires a emergency response or a trip to the hospital. You should call 911 in the following situations involving a seizure.
This is the person’s first seizure.
The person remains unconscious or has trouble breathing after seizure activity ends.
The seizure lasts longer than 5 minutes.
Another seizure occurs shortly after the first seizure stops.
The person has suffered a serious injury during the seizure.
The seizure occurs in water.
When in doubt, it is ok to call 911 if a person in your care is experiencing a seizure and cannot speak on their own behalf.
Preparing for a Seizure
If a child in your care has been diagnosed with a condition or disorder that makes them more likely to have a seizure, use the following resources to help you, your child, and your child’s secondary caregivers, teachers and coaches prepare for the possibility of a seizure.
Work with your child’s medical care team to create a seizure action plan, using this template from The Epilepsy Foundation. Share this action plan with your child’s school leadership, teachers, and coaches, and print copies for your child to take to sleepovers or playdates with their friends.
Consider acquiring a medical alert accessory for your child to wear or carry that identifies their medical condition and can lead a first responder to their seizure action plan.
Provide this seizure and epilepsy education resource kit from the CDC and this guide from The Epilepsy Association to your child’s school. These resources can help them to be prepared if any student experiences a seizure.
The Epilepsy Foundation has a suite of tools and resources for individuals who are prone to seizures. On this page you'll find a seizure diary app to help log seizure activity and events, lists of devices and medications that can help control seizures or improve quality of life for individuals who suffer from seizures, and a variety of social support resources.
Contributed by: Sebastian Cappeta, Pre-medical Neuroscience Student, Bachelor of Science Case Western Reserve University, 2023