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Keep them safe from secondary injury

Seizures can be scary. 

As a friend or bystander, it can be very difficult to maintain composure, but by knowing how to respond, you can help the person suffering the seizure avoid secondary injuries.

“Very often, the seizure itself isn’t a huge risk to someone’s health,” explained Dr. Abuhuziefa Abubakr, director of epilepsy for Geisinger. “The dangers that come from seizures are associated with secondary factors like what caused the seizure, trauma from falling down, hitting their head or being in an unsafe area. When someone has a seizure near you, the most important thing is to keep them safe and comfortable until the seizure stops.”  

There are two main types of seizures—focal seizures and generalized seizures. In a focal seizure, a person may become completely unresponsive or confused. There are a number of different types of generalized seizures, including a “tonic-clonic seizure,” which is what most people think of when they think of a seizure. In a tonic-clonic seizure, you may see someone lose control of their body, have convulsions and drop to the ground. 

To help someone having a seizure, remember the acronym S.K.I.M.—secure the area, keep them comfortable, inform emergency services and monitor their condition.

Secure the area
“When someone is having a seizure, it’s best to let the seizure run its course and avoid moving them,” said Dr. Abubakr. “Sometimes, this isn’t possible, though. If the scene around the person is dangerous, it needs to be secured, or they need to be moved. Try to be as gentle as possible if you need to move them.”

The first thing you should do is make sure that the area is safe for someone in the midst of a seizure. Guide them to the ground to prevent them from hitting their head if they fall. If something nearby could pose a danger, such as equipment or furniture, move them to a safe area or get hazardous objects out of the way. 

Keep them comfortable
During and after the seizure, it is important to keep them comfortable and help them avoid injury. 

Place a towel or cushion under their head and loosen any tight-fitting clothing or jewelry around their neck if you can. Turn their head sideways to allow any fluids such as saliva and vomit to drain out, but do not restrain them in any way; this can cause injuries such as a dislocated shoulder. Do not put anything in their mouth or give them something to drink.

Inform emergency services
While not all seizures require emergency medical attention, some do. If the seizure meets any of the following criteria, call 911.

  • They stop breathing for more than 30 seconds. You should also begin performing rescue breathing.
  • They are pregnant.
  • They are diabetic.
  • They experience more than one seizure in 24 hours.
  • They develop a fever.
  • The seizure lasts more than five minutes.
  • They sustain a head injury.
  • They don’t respond normally within an hour.
  • The seizure is a result of ingesting poison or inhaling fumes.
  • The seizure starts after they complain about a sudden, severe headache.
  • They have trouble walking, speaking or thinking clearly.
  • They complain of severe pain.

Monitor the situation
Check to see if they have an ID card or identification jewelry noting that they have epilepsy. This can give you more information on how long the seizure should last and what to expect. A normal seizure should not last more than 60 to 150 seconds. If possible, you should time how long the seizure lasts and take note of how they were acting before and after the seizure.

“After a seizure, some people are confused or feel very sleepy when they wake up,” said Dr. Abubakr. “However, if their condition doesn’t improve after a short time, you may want to help them get medical attention.”

Abuhuziefa Abubakr, M.D., is a neurologist who specializes in epilepsy and serves as director of epilepsy for Geisinger. He sees patients at Geisinger Community Medical Center in Scranton, Geisinger Wyoming Valley Medical Center in Wilkes-Barre and Geisinger Medical Center in Danville. To schedule an appointment with Dr. Abubakr or another Geisinger neurorologist, call 800-275-6401 or visit Geisinger.org.