Managing seizures

This page covers managing seizures and includes links to download a template and infographic that will help you keep accurate seizure records. 

Seizure first aid 

Watching a baby, child or young person having a seizure can be very frightening, even if it only lasts for a few seconds. 

Most seizures stop without the need for any treatment, but it’s important that you follow a few simple steps to keep a child safe. 

1. Stay calm and make sure they are in a safe place with space to move freely and nothing in the way that will interfere with their breathing. 
   It’s also important to record how long the seizure lasts, so try to remember to start timing it. 
2. Let the seizure run its course. Don’t restrict their movements or put anything in their mouth. 
3. Once the seizure ends, put the child onto their side to recover. This will help to keep their airway clear. 
4. Make a note of what happened leading up to and during the seizure, and after it ended. 

You must get medical help urgently by calling 999 for an ambulance if the child or young person: 

• Has never had a seizure before 
• Isn’t breathing or is blue around the lips 
• Has a seizure lasting for more than five minutes 
• Isn’t responding to you after the seizure has stopped 
• Is injured during the seizure 

Keeping accurate seizure records  

As soon as you can, take time to sit down and write a description of exactly what happened.  

Make a note of: 

• Any changes in breathing 
• Movements of arms and legs 
• How long it took for the baby to fully recover 
• Head movements 
• Eye movements 
• Medication given 
• How long the movements or behaviours lasted 
• Skin colour 
• Changes in how the baby responds to you 

It’s also helpful to note what you were doing before the seizure started and when it happened. 

Don’t forget to keep a diary with the exact times and dates. 

It will be very helpful if you can make a video recording of seizures. But always make sure the child is safe before worrying about a recording. 

Download ‘Keeping records’ infographic.

Witnessing a seizure 

Witnessing a seizure can be stressful and it’s easy to forget some of the details.  

If you witness a seizure, it’s important that you write down the details on a ‘Witnessing a Seizure’ form as soon as possible. 

Where possible, anyone involved in the care of a child or young person should do this every time they witness a seizure.  

Download 'Witnessing a Seizure' form (template)

Give a detailed description of what happened before, during and after the seizure.  

It’s best just to describe what you saw rather than trying to identify the type of seizure. 

That way, you’re less likely to miss important information. 

This information will help doctors to: 

• Make a correct diagnosis 
• Identify patterns and changes in the child’s condition 
• Decide the best way to manage and treat their condition 

Managing a tonic-clonic (convulsive) seizure in children and young people 

Tonic-clonic seizures used to be called grand mal seizures. They are the type most people recognise. 

When a child or young person has a tonic-clonic seizure, they go stiff, lose consciousness, fall to the floor/ground and begin to jerk or convulse.  

They may also go blue around the mouth because their breathing is irregular.  

Sometimes, they can lose control of their bladder or bowels and bite their tongue or the inside of their mouth. So, be aware of their privacy and dignity and cover with a blanket, if possible. 

If you see someone having a tonic-clonic seizure, follow these steps: 

1. Time how long the seizure lasts. 
2. Keep calm. This isn’t always easy, but it’s very important, especially when the person is recovering from the seizure and looking to you for reassurance. 
3. If the person has a warning (aura) that a seizure is coming, try to get them to sit or lie down to reduce the risk of injury. 
4. Don’t move the person unless absolutely necessary, e.g. if they are close to a hazard that cannot be moved, such as an open fire, roads or open water. 
5. Prevent physical injury by moving other hazards, such as furniture, out of the way. 
6. If they are wearing glasses, remove them. 
7. Put something soft under their head to protect it from banging on a hard surface. If there’s nothing to hand, cradle their head in your hands or on your lap. 
8. Don’t restrain their movements. 
9. Maintain their dignity and privacy as much as possible. 
10. Loosen tight clothes around the neck. 
11. Wipe away excess saliva. 
12. Never put anything – especially not your fingers – in their mouth. 
13. When the jerking has stopped, roll them onto their side.
14. Let the seizure run its course. 
15. Stay with them until the seizure stops. 
16. Keep a record of the seizure, including how long it lasted, when it started and when it finished, and a brief description if the seizure was different from the type they normally have. 

 Call an ambulance if: 

• This is their first seizure 
• They injure themselves or have breathing difficulties 
• The seizure lasts more than five minutes or is two minutes longer than their usual seizure 

 Find out more about tonic-clonic seizures. 

Managing a focal onset seizure 

Focal onset seizures happen when there’s abnormal electrical activity in one part of the brain. 

If you see someone having a focal seizure, follow these steps: 

1. Time how long the seizure lasts. 
2. Reassure them by speaking quietly and calmly to them. 
3. Guide them away from danger, such as roads, open water or open fire. 
4. Don't restrain them. 
5. Don't do anything that could frighten them, such as making abrupt movements or shouting at them. 
6. Don't assume they’re aware of what’s happening or what has happened. 
7. Don't give them anything to eat or drink until they’re fully recovered.
8. Don't try to bring them round. 
9. Stay with them until they’re fully conscious and any confusion has stopped. 
10. Explain anything that they have missed. 
11. Keep a record of the seizure, including how long it lasted, when it happened and what it looked like.  

Call an ambulance if: 

• This is their first seizure 
• The seizure lasts more than five minutes or is two minutes longer than their usual seizure 
• If it’s a focal onset seizure and lasts more than 10 minutes 
• They have one seizure after another without becoming aware again between seizures 
• They injure themselves or have breathing difficulties 

Status epilepticus 

A convulsive seizure that lasts for five minutes or more is known as ‘status epilepticus’. 

When this happens, the person should be given emergency treatment. If the seizure approaches five minutes, call 999. 

If the person has an individualised emergency management plan, it should be followed. 

Find out more about status epilepticus and emergency or rescue medication.