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Freedom251 › Blog › CDC guidance

Seizure First Aid: What to Do and What to Avoid

By Freedom251 Team · · 9 min read

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If someone is having a seizure, stay with them, protect them from nearby hazards, start timing the event, and keep calm. If they are on the ground, gently turn them onto one side with their mouth angled toward the ground. Do not restrain them, put anything in their mouth, give food or water, or give mouth-to-mouth breaths during the seizure.

Most seizures do not require an ambulance, but call 911 in the United States when the seizure lasts longer than five minutes, another seizure follows soon after, breathing or waking is difficult afterward, an injury occurs, or the seizure happens in water. CDC guidance also identifies a first-ever seizure, diabetes with loss of consciousness, and pregnancy as reasons to call.

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Recognize that seizures do not always look like shaking

A seizure is a burst of abnormal electrical activity in the brain. The event may be dramatic, with a person falling stiffly and jerking rhythmically, but it can also be subtle. The Centers for Disease Control and Prevention (CDC) says seizures may involve confusion, staring, wandering, unusual movements, or an inability to answer questions. A person might not fall or make noise at all.

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CDC classifies focal seizures as starting on one side of the brain. They can alter awareness, behavior, sensation, or movement. Generalized seizures begin, or appear to begin, on both sides of the brain. A generalized tonic-clonic seizure can include loss of consciousness, stiffening, rhythmic jerking, confusion, and marked tiredness afterward. These descriptions help a bystander recognize a possible seizure, but they do not identify its cause or replace medical evaluation.

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CDC estimates that about 1 in 10 people in the United States may have a seizure during their lifetime. That population statistic, cited by CDC on its 2024 page, is not a prediction of an individual person’s risk.

Whatever the appearance, use the same practical priorities: stay, protect, time, position when appropriate, and assess recovery. The person’s movements may change during the event; do not try to diagnose the seizure type while it is happening.

The first-aid sequence: stay, protect, time, position, recover

1. Stay with the person and keep the area calm

Remain with the person from the start of the event through recovery. Ask others to give space and keep their voices low. Your calm presence reduces crowding and lets you notice the duration, breathing, injuries, and changes in awareness that emergency responders may need to know.

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Do not leave to search for medication or to make a phone call unless another responsible adult can take over. If an emergency call is necessary, have someone else call 911 while you continue watching the person.

2. Protect against nearby hazards

Move hard, sharp, hot, or unstable objects out of reach. Clear furniture, tools, glass, cookware, or other items that could strike the person. If the person appears to be falling, ease them to the ground rather than trying to catch them upright.

For a generalized seizure, CDC specifically advises placing something soft and flat under the head, removing glasses, and loosening restrictive clothing around the neck. Use only a light cushion or folded garment; do not place bulky objects under the neck or attempt to hold the head still.

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3. Start timing as soon as the seizure begins

Use a phone clock, watch, or another reliable timer and note the start time. A seizure can feel longer than it is, and the exact duration determines when emergency help is required. If the event stops and then another begins, note both the end and restart times.

Record useful observations for responders: whether the person fell, whether one side moved differently, whether there was an injury, whether the person was in water, and whether normal breathing and alertness returned afterward. Do not delay protection or a 911 call to write a detailed account.

4. Turn a person who is lying down onto one side when appropriate

If the person is lying down, gently roll them onto one side, with the mouth angled toward the ground. This position helps keep the airway clear of saliva or vomit. Move slowly and avoid forcing a joint or twisting the body against strong movements.

Do not attempt to turn someone in a way that could worsen a suspected serious injury. If you cannot position the person safely, keep the area clear, watch breathing, and follow the instructions of the 911 dispatcher.

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5. Let the seizure end without trying to stop the movements

Jerking, stiffening, wandering, or unusual movements generally stop on their own. Keep objects away and protect the head, but do not pin the person’s arms or legs and do not attempt to force them into a particular posture. Restraint can injure the person or the helper.

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What to avoid during a seizure

  • Do not restrain the person. Holding them down can cause injuries to muscles, joints, or both people involved.
  • Do not put anything in the mouth. A spoon, finger, cloth, or another object can damage teeth or the jaw. A person cannot swallow their tongue, and forcing an object between the teeth creates a new hazard.
  • Do not give food, water, pills, or other liquids until the person is fully alert. Reduced awareness makes choking possible.
  • Do not give mouth-to-mouth breaths during the seizure. CDC says people usually begin breathing again after the seizure ends. Concentrate on keeping the area safe and observing the person instead.
  • Do not crowd, shout at, shake, or surround the person. These actions do not stop the seizure and can make the scene harder to manage.
  • Do not attempt an unplanned rescue-medication routine. General public guidance cannot substitute for the person’s own clinician-written seizure action plan. If a prescribed plan is available and you are trained and authorized to follow it, use that plan; otherwise ask emergency dispatch for instructions.

When to call 911 in the United States

CDC says seizures do not usually require emergency medical attention, but the following situations require a 911 call. Tell the dispatcher that a seizure is occurring or has just occurred, give the location, and report the time and any danger such as water or injury.

Call 911 when… What to tell responders
The seizure lasts longer than five minutes. Give the exact start time and whether movements have stopped.
Another seizure starts soon after the first. Explain when the first event ended and the next one began.
The person has trouble breathing or waking after the seizure. Describe breathing, responsiveness, and any change from normal.
The person is injured. Identify visible injuries and how the person fell or was struck.
The seizure happens in water. State that the event occurred in water and describe the person’s current condition.
It is the person’s first-ever seizure. Say that no previous seizure is known, if that is the case.
The person has diabetes and loses consciousness. Report the diabetes and the loss of consciousness.
The person is pregnant. Tell dispatch that the person is pregnant and describe the seizure and recovery.

Back-to-back seizures within a five-minute period can increase the risk of brain injury or death. CDC calls this pattern status epilepticus, a medical emergency. Do not wait for a later seizure to end before calling when the five-minute threshold or another emergency condition has been reached.

Emergency numbers differ outside the United States. Replace 911 with the number used where you are, and follow local dispatcher instructions.

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What to do after the movements stop

Check recovery without rushing the person

When the seizure ends, help the person sit in a safe place to recover, as CDC advises. If they remain drowsy or confused, keep them away from stairs, traffic, machinery, water, and other hazards. Continue observing breathing and responsiveness. Confusion and exhaustion can last after a generalized tonic-clonic seizure.

Do not offer food, water, or medication until the person is fully alert and able to swallow normally. If breathing or waking is difficult after the seizure, call 911 rather than assuming the person simply needs sleep.

Explain what happened when the person is alert

Once the person can understand you, speak simply and reassure them. Tell them that they had a seizure, how long it appeared to last, and whether they fell, were injured, or were in water. Avoid judging or demanding an immediate explanation; post-seizure confusion can make questions overwhelming.

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Offer to contact a friend, relative, caregiver, or other trusted person who can help them get home safely. A person who is still confused, weak, injured, or unable to walk safely should not be left alone to travel.

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Adjust the response to the situation

If the person is falling

Guide the fall toward the ground if you can do so safely. Once down, remove glasses, clear hazards, cushion the head with something soft and flat, and loosen restrictive neckwear. Do not try to keep the person standing or carry them during active movements.

If the person is already on the ground

Clear the surrounding area, protect the head, time the seizure, and turn the person onto one side when it can be done safely. Avoid unnecessary movement, especially if there may have been a significant impact.

If the event looks like staring, wandering, or brief confusion

Stay nearby and prevent the person from entering traffic, climbing, touching hot surfaces, or walking into water. Do not grab or argue with them. Once they can respond, guide them to a safe place and explain what you observed. A seizure that does not include shaking can still require emergency help if it is a first seizure, repeatedly occurs, lasts longer than five minutes, or leaves the person unable to breathe or wake normally.

If the seizure occurs in water

Call 911 immediately and tell dispatch that the seizure happened in water. Water involvement is an emergency exception in CDC guidance. Prioritize your own safety; do not undertake a rescue that puts you at risk. Follow the dispatcher’s instructions while watching the person’s breathing and condition.

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If another seizure starts soon afterward

Continue timing and call 911. Tell dispatch that the events are recurring and provide the start and stop times you recorded. Do not give food, water, or anything by mouth between events unless the person is fully alert and emergency professionals direct you otherwise.

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Prepare before an emergency happens

Learn the person’s written plan

For someone with known epilepsy, ask the person, caregiver, school, workplace, or coach where the individualized seizure action plan is kept. A plan may contain clinician-approved instructions, emergency contacts, and the person’s usual recovery pattern. Follow only instructions you are trained and authorized to use; the general steps in this article do not replace that plan.

Use medical identification

A medical ID bracelet or similar identification can help a bystander find information about conditions, medicines, and emergency contacts when the person cannot answer. CDC specifically advises checking for one. It is an aid for communication, not a guarantee that an emergency will be prevented.

Take formal first-aid training

CDC notes that free, online, on-demand seizure first-aid training is available through the Epilepsy Foundation. It can be especially useful for people who live with someone with epilepsy, coaches and group leaders, and workers in schools or other public settings. Training can make it easier to recognize less obvious seizures, delegate the 911 call, and describe what happened accurately.

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A simple bystander checklist

  1. Stay with the person and ask others to remain calm.
  2. Clear nearby hazards; ease a falling person to the ground.
  3. Protect the head, remove glasses, and loosen restrictive neckwear for a generalized seizure.
  4. Turn a person who is lying down onto one side, with the mouth toward the ground, when safe.
  5. Start timing and note injuries, water involvement, breathing, and recovery.
  6. Never restrain the person or put anything in their mouth.
  7. Withhold food and water until full alertness returns; do not give mouth-to-mouth breaths during the seizure.
  8. Call 911 for any CDC emergency exception, especially a seizure lasting longer than five minutes or another seizure soon after.
  9. Afterward, help the person sit somewhere safe, explain what happened when they are alert, and arrange safe support getting home.

The goal is not to stop the seizure yourself. It is to prevent avoidable injury, recognize when emergency care is needed, and support the person through recovery.

For current public guidance, see the CDC’s First Aid for Seizures, Types of Seizures, Health and Safety Concerns, and Epilepsy Basics pages. CDC’s school-focused archived material is available at Epilepsy — Healthy Schools.

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