Seizure emergencies

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HealthWiki > Epilepsy and Seizures > Chapter 2: How to help a person having a seizure > Seizure emergencies

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In this chapter:

 

In this chapter:

• Chapter 2: How to help a person having a seizure
• First aid for seizures
• Seizure emergencies
• After the seizure
• Other problems that can happen with seizures
• When to see a health worker
• Training the community in seizure first aid

Although most people who have epilepsy or seizures recover fully after just a few minutes, some seizures are medical emergencies. Medical help and emergency action are needed:

If a person has a seizure that lasts longer than 5 minutes (status epilepticus)

Status epilepticus is usually not one but many seizures with little or no recovery time between them.

If a seizure lasts longer than 5 minutes and the person cannot speak or respond, you need to look in their pocket or bag or backpack for emergency medicine or information. Tell others nearby that you are looking for instructions to help.

A person in status epilepticus needs emergency medicine. They often carry a medical ID card, bracelet, or necklace along with their emergency rescue medicine. Their emergency medical information should explain:

• the type and dose of rescue medicine to give.
• how and when to give it.
• when to call medical help or take the person to a clinic or hospital.

Rescue medicine is different from daily medicine a person takes for seizures. It is intended for use only in emergencies. It is commonly given in 2 ways:

Emergency pill

By mouth. Some rescue medicines come as a pill that dissolves quickly under the tongue or between the cheek and gum. Do not attempt this if the person is actively convulsing and there is a risk they might choke on medicine or involuntarily bite you.

As a nasal spray. Some rescue medicines come as a nasal spray. If you find this type of medicine, follow its instructions carefully. Usually you will spray the medicine into only one nostril. The person does not need to be awake for nasal spray medicine to be effective.

For more information about status epilepticus, see Chapter 3. For more information about emergency medicine, see Chapter 4.

IMPORTANT! Do not restrain a person during a seizure. Stay with them until the seizure ends and they fully recover or medical help arrives.

If a person has a seizure while swimming

Get them out of the water as fast as you can and call for help if needed. If they are breathing, follow basic seizure first aid steps. If they are not breathing, and you know how, immediately start rescue breathing and chest compressions. For information about how to do rescue breathing and chest compressions, see Hesperian’s Pocket Where There Is No Doctor: First Aid.

If a person has a seizure in the bathroom

If a person has a seizure in the bathroom, first try to move them away from any water to prevent drowning. If you cannot move them, focus on keeping their head above water. If the bathroom door is locked and you suspect someone is having a seizure, you may need help to open the door. Once the person is safe from water, follow basic steps for seizure first aid. To avoid falling while bathing, it is safest to sit on a stool or chair. If heat is a seizure trigger, avoid using very hot water.

If a person falls from a height

If a person has a seizure and falls from a height, like down the stairs, off a ledge, or from a ladder or roof, they may get seriously injured and need emergency medical help.

Do not move the person unless they are in immediate danger, for example, from traffic or fire. If they have broken bones, especially in their head, neck, or back, moving them could make their injuries worse.

If they are breathing and safe where they are, stay close, keep them comfortable, and wait for medical help to arrive. If they are not breathing, immediately start rescue breathing and chest compressions if you know how.

If a person has difficulty breathing or stops breathing after a seizure

During a seizure, breathing may stop briefly but it should return after the seizure has passed. If the person does not start breathing again, call for help and, if you know how, immediately start rescue breathing and chest compressions.

For information about how to do rescue breathing and chest compressions, see Hesperian’s Pocket Where There Is No Doctor: First Aid.

If a person does not regain consciousness after a seizure

If the person is not responsive after a seizure, immediately call for help.

If a person chokes on food or drink during a seizure

When a person has a seizure while eating or drinking, there is a small chance that food or liquids may get stuck in their throat or airway, blocking their breathing and making them choke.

Because breathing often stops briefly during a seizure, it may be difficult to know if breathing has stopped due to choking or due to the seizure itself. Breathing that stops due to a seizure will start again after the seizure has passed. But if breathing stops because of choking, it may not restart without action.

After the seizure ends, check if the person is breathing by looking for movement (their chest rising and falling) and listening to or feeling for air coming in or out of their mouth or nose. If the person has fallen, roll them onto their side to prevent any risk of swallowing food or vomit that can block breathing.

If the person is conscious but cannot breathe and you suspect they are choking, ask them to open their mouth so you can look inside to check for food. Use your small finger to sweep any food out of the mouth so it does not block the airway. Only use a finger sweep if you can clearly see food or an object blocking the airway.

IMPORTANT! Do not push the food deeper into their throat. Also, be aware that the

person’s involuntary movements might lead them to bite your finger.

If breathing remains blocked, you can try giving abdominal thrusts (the Heimlich maneuver). For babies and pregnant people, give back blows instead.

How to give abdominal thrusts

If the person is on a bed or chair, move them onto their back on the floor. A floor is a solid, firm base upon which to do this rescue action. While kneeling beside their upper body:

• Find the person’s navel (belly button).
• Make a fist. Curl your fingers and tuck your thumb beneath the fingers, into the palm.
• Put your fist just above their navel but below their ribcage and hold it with your other hand on top.
• Use both hands to push toward the rib cage with a sudden jerk. Do this quickly, 3 to 5 times.
• Repeat this a few times to push increasing amounts of air through the person’s lungs and windpipe to drive out whatever is blocking breathing.

Do not give abdominal thrusts to a person who is:

Unconscious. Abdominal thrusts work partly because they rely on a person’s ability to forcefully cough out what is stuck in their airway. An unconscious person may not be able to do this.

Pregnant. Strong force applied during an abdominal thrust can injure the womb, threatening the life of the pregnant person and the baby. Instead, see “How to give back blows to a pregnant person lying down”.

A baby. Abdominal thrusts are too strong for a baby’s small, delicate body. Instead, see “How to give a back blow to a baby”.

WHEN TO GET HELP

If breathing does not start right away, call for help or take them to a nearby clinic or hospital immediately.

How to give back blows

How to give back blows to a pregnant person lying down. Turn the pregnant person on their side and place a cushion under their hip to tilt their body and the pregnancy slightly forward.

• Get on your knees behind the person’s back.
• Gently hold their head in the palm of one of your hands.
• Use the bottom portion (the “heel”) of your other hand to hit the person in the middle of their back, between the shoulder blades. Do not hit too hard.
• Repeat this 5 times or more until the food blocking the breathing is pushed out of the airway and mouth. After recovery, the person should contact a midwife or doctor so they can check on other health issues related to pregnancy.

How to give back blows to a baby.

• Hold the baby face down with their head lower than their body.
• Use the bottom portion (the “heel”) of your hand to give 5 firm blows between the shoulder blades.
• Repeat this 3 to 5 times or more until the baby breathes.
• If breathing does not return, try giving gentle chest thrusts with your fingers.

WHEN TO GET HELP

If breathing does not start right away, call for help or take them to a nearby clinic or hospital immediately.

As soon as the person is breathing, encourage them to cough if food is still partially blocking their airway. Offer water after the airway is no longer blocked. If a person is not able to cough, it could be because food is still stuck and blocking their airway.

This page was updated:19 May 2026