Not all seizures result in a person jerking about uncontrollably. With many seizures, the person may simply smack their lips, seem to be oblivious to their surroundings, wander around mindlessly, stare off into space, or the like. In these cases, there is often little to be done. If they are wandering around, you should gently guide them away from dangers, such as walking into the street, but otherwise don’t try to restrain or “wake” them. Emergency medical aid is typically not needed unless they’ve hurt themselves seriously somehow or if the seizure lasts for more than five minutes (you should time it). Other than that, just stay with them and wait for the seizure to end.
For tonic-clonic seizures (the kind where they jerk around), there’s also not usually a lot to be done, but there are a few things that can be helpful. Contrary to popular belief, one of things is not “put something in their mouth to hold down their tongue to keep them from swallowing or biting it”. That’s actually one of the worst things you can do for someone having a seizure. Well, I suppose kicking them upside the head or otherwise intentionally seriously harming them would technically be worse, so I should say “one of the worst things someone trying to help them can do”.
The person having a seizure isn’t going to swallow their tongue (this is impossible, also contrary to popular belief) and someone trying to jam something in their mouth is very likely going to end up injuring them: chipping their teeth, puncturing their gums, possibly breaking their jaw, or even jabbing or puncturing the back of their throat. Depending on what you used, the seizure victim might even choke on what was jammed in their mouth. The person trying to force the thing in their mouth can also end up getting their fingers bitten severely, if they aren’t careful, and it’s hard to be careful when someone’s jerking about uncontrollably.
While it’s not possible for someone to swallow their tongue, it is possible, depending on the size and position of a person’s lingual frenulum (the small membrane that extends from the bottom of your mouth to the middle part of the tongue), for some people to have their tongue in its fully relaxed state go limp and partially or, in rare cases, fully obstruct their airway, assuming they’re on their back. This isn’t too common, but can happen. There is no need to stick your fingers or anything else in their mouth to fix this, though. All you have to do is roll them on their side and gravity will do the job for you.
In fact, this is actually what you should ultimately do for people having tonic-clonic seizures, though more to stop bodily fluids, such as vomit, from running back down their throat causing them to choke on it.
Specifically, what to do if you see something having a tonic-clonic seizure is:
- Clear any objects away that are around the person having the seizure, so they don’t injure themselves on them.
- If you have something soft handy, like a jacket, gently slide it under their head.
- Time the seizure. If it lasts for more than five minutes or repeated seizures occur without the person waking up in between or if the person seems to have seriously injured themselves, call an ambulance. (Again, calling emergency medical aid usually isn’t necessary for people having seizures).
- Once the seizure is done, roll them onto their left side and wait for them to wake up. If, after the seizure, you notice they aren’t breathing (this is rare), call an ambulance and follow the emergency care advice given by the emergency operator.
While they’re having the seizure, you shouldn’t try to restrain them in any way, unless of course they are having a seizure next to a cliff, I suppose, or otherwise might seriously injury themselves if you don’t move them. But in most cases, it’s best to leave them be and wait for the seizure to run its course.
One caveat to the “you don’t usually need to call for emergency medical aid” is if you happen to know that this is the first time someone has ever had a seizure. In those cases, you should call an ambulance.
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