What should others do if I have a seizure? 

When a seizure occurs, the most important role for a bystander is to remain calm and ensure the environment is safe until the event concludes naturally. For most people witnessing a seizure, the primary instinct is to intervene physically, but in a clinical sense, the best care is often minimal interference. Most seizures are self limiting, meaning they will stop on their own within a minute or two without any medical intervention. By following a structured set of first aid steps, friends, family, and colleagues can prevent injury and provide the necessary support during the recovery phase. 

Clear communication about what others should do is a vital part of your personal safety plan. When people know exactly how to react, it reduces the panic and confusion that can occur during an emergency. The goal of seizure first aid is to protect the individual from physical harm, monitor the duration of the event, and ensure they are comfortable as they regain consciousness. This proactive approach not only keeps you safe but also gives your support network the confidence to handle a seizure effectively in any setting. 

what we will discuss in this article 

• The core principles of seizure first aid using the Stay Safe Side protocol 

• Specific actions to avoid during a seizure to prevent injury 

• How to manage different types of seizures including focal and tonic clonic 

• Managing the recovery phase and providing reassurance 

• Identifying the specific clinical triggers for calling emergency services 

• The role of rescue medications and when they should be administered 

• Emergency guidance for identifying signs of health deterioration 

The Stay Safe Side protocol 

The most widely recognized clinical guideline for seizure first aid is the Stay Safe Side approach, which provides a simple framework for bystanders. 

Stay Safe and Side 

First, others should stay with you and time the seizure from the moment it begins. This timing is critical because it determines if emergency services are needed. Second, they must keep you safe by moving any hard or sharp objects away and placing something soft, like a folded jacket, under your head to prevent injury from the ground. They should never try to restrain your movements or move you unless you are in immediate danger, such as near a busy road or water. Finally, once the jerking movements stop, they should turn you onto your side in the recovery position to help keep your airway clear. 

Actions to avoid 

Knowing what not to do is just as important as knowing the correct first aid steps, as certain common myths can lead to dangerous interventions. 

Preventing secondary injuries 

It is a dangerous myth that a person can swallow their tongue during a seizure. Others must never put anything in your mouth, including food, drink, or objects like spoons or fingers. Attempting to do so can result in broken teeth, bitten fingers, or a blocked airway. Furthermore, bystanders should never attempt to hold you down or stop your movements. Forcing a person to stay still during a seizure can lead to muscle tears or bone fractures. The safest course of action is to let the seizure run its course while providing environmental protection. 

Comparison of first aid for different seizure types 

Seizure Type	Bystander Action	What to Watch For
Tonic Clonic	Stay Safe Side protocol	Loss of consciousness, jerking
Focal Aware	Stay with you, provide reassurance	Confusion, repetitive movements
Absence	Stay and monitor until fully alert	Blank staring, brief pausing
Focal Impaired	Guide away from danger, do not grab	Wandering, picking at clothes
Seizure in Water	Support head above surface, get out	Inhalation of water, drowning risk

Managing the recovery phase 

The period after a seizure, known as the postictal phase, is a time of vulnerability where you will need continued support. As you begin to wake up, you may feel very confused, tired, or embarrassed. Others should stay with you until you are fully alert and aware of your surroundings. They should talk to you calmly and explain what has happened, as you likely will not remember the event. It is helpful if they can provide a quiet space for you to rest. They should not offer you anything to drink or eat until they are certain you are fully conscious and able to swallow safely. 

When to call for an ambulance 

While most seizures do not require a hospital visit, there are specific clinical situations where calling 999 is essential. 

Emergency triggers 

Others should be instructed to call emergency services immediately if: 

• The seizure lasts more than five minutes. 

• You have a second seizure shortly after the first without regaining consciousness. 

• You are injured during the seizure, especially if you hit your head. 

• The seizure happens in water. 

• You have difficulty breathing or stay blue in the face after the seizure ends. 

• It is the first time you have ever had a seizure. 

• You are pregnant or have other serious health conditions like diabetes. 

To summarise 

Seizure first aid is centered on the principles of safety, timing, and calm observation. By teaching others the Stay Safe Side protocol and ensuring they understand what to avoid, you create a reliable safety net that protects you during and after an event. Most seizures are manageable with simple environmental adjustments and compassionate support. Ensuring your friends and family are well informed about your specific needs and have access to your seizure action plan is the most effective way to manage the risks associated with epilepsy in daily life. 

Emergency guidance 

If you or someone else has a seizure that does not follow the usual pattern, it must be treated with urgency. Call 999 immediately if a seizure lasts longer than five minutes or if there is any sign of physical injury. If a person does not start to wake up after the movements have stopped, or if their breathing remains irregular, this is a medical emergency. Once the emergency has passed, you should contact your specialist to review the event. Any seizure that requires emergency intervention suggests a need to re evaluate your current management plan to ensure your long term safety. 

Authority Snapshot 

Dr. Rebecca Fernandez is a UK trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence based approaches such as CBT, ACT, and mindfulness based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well being in 2026.