Seizures & Fits
Most seizures stop on their own within two minutes. Your job is to protect the head, time it, and keep everything out of their mouth.
When to call an ambulance immediately
- The seizure lasts longer than 5 minutes
- A second seizure follows without full recovery in between
- It is their first ever seizure
- The person is pregnant, diabetic, or has a serious head injury
- The seizure happened in water
- Breathing does not return to normal, or they do not regain consciousness afterwards
- They are injured during the seizure
What to do
Work through these in order. If you are alone, put your phone on speaker so the 108 call handler can guide you while your hands stay free.
- 1
Stay calm and start timing
Look at a clock the moment it starts. Duration is the single most useful piece of information you can give the ambulance crew, and it determines whether emergency medication is needed.
- 2
Protect the head and clear the space
Slide something soft such as a folded jacket or cushion under the head. Move away furniture, hot drinks, sharp edges and anything hard. Loosen tight clothing around the neck and remove spectacles.
- 3
Let the seizure run its course
Do not try to hold the person down or stop the movements. You cannot shorten a seizure by restraining it, and forcing limbs still causes dislocations and fractures.
- 4
When the jerking stops, turn them on their side
Place them in the recovery position so saliva and any vomit drain out of the mouth rather than into the lungs. Tilt the head gently back to keep the airway open.
- 5
Stay with them while they come round
Confusion, drowsiness, agitation and no memory of the event are all normal afterwards, and can last from minutes to an hour. Speak calmly, tell them where they are and what happened, and stay until they are fully oriented.
- 6
Call 108 for any red flag
In particular, a seizure lasting more than five minutes is status epilepticus and is a genuine emergency needing immediate treatment.
Never do these
Most of these are well-intentioned and widely believed. All of them make the situation worse.
- Never put anything in the mouth. Not a spoon, not a finger, not a cloth, not a wallet. It is impossible to swallow your own tongue, and forcing objects in breaks teeth, injures the jaw and has caused rescuers to lose fingertips.
- Never restrain the person or try to hold their limbs still.
- Never make them smell onions, shoes, or anything else. It does nothing and delays the things that matter.
- Never throw water on their face or try to make them drink during the seizure.
- Never give food, water or tablets until they are fully awake and able to swallow safely.
- Never crowd around. Ask onlookers to step back and give them dignity and air.
Once the immediate danger has passed
- Note what you saw: how it started, which parts of the body moved, how long it lasted, and how long recovery took. This description is genuinely diagnostic.
- A first-ever seizure always needs medical assessment to find the cause.
- For someone with known epilepsy who recovers fully, follow their existing care plan. Not every seizure needs an emergency department.
Frequently asked
Why is the spoon-in-the-mouth myth so dangerous?
It is the single most common and most harmful piece of seizure folklore. The tongue cannot be swallowed. Forcing an object between clenched teeth breaks them, can push fragments into the airway, and injures whoever is doing it. It also wastes the seconds that should be spent protecting the head.
Should I hold their tongue?
No. Turning the person on their side once the jerking stops does everything that needs doing for the airway.
Reviewed and written by
Dr. Poonam Sekhon Chahal, MBBS, MEM
Senior Emergency Physician, Manipal Hospital, Patiala · Certified in ACLS, ATLS, PALS and PoCUS