Seizure First Aid: What to Do When Someone Has a Seizure (2026)

By SKLD Training - 2026-02-12

Do not hold them down. Do not put anything in their mouth. Protect their head, clear the area, time the seizure, and call 000 if it lasts more than five minutes. This guide covers the correct first aid response for tonic-clonic seizures, what to expect during and after a seizure, and when it becomes a medical emergency.

What to Do When Someone Has a Seizure

A seizure can look terrifying - the person collapses, their body convulses, they may go rigid, make unusual sounds, or lose control of their bladder. Most people's instinct is to hold them still or put something in their mouth. Both of these responses are wrong and can cause serious harm.

Here is what you actually do:

Stay calm. Most seizures stop on their own within one to three minutes.
Time it. Check the clock when the seizure starts. This is critical information for paramedics.
Clear the area. Move hard or sharp objects away from the person.
Protect their head. Place something soft - a folded jacket, your hands - under their head to prevent injury on the ground.
Do not hold them down. You cannot stop a seizure by restraining the person. Restraint risks injuring them and you.
Do not put anything in their mouth. People cannot swallow their tongue. Putting objects in the mouth causes broken teeth, jaw injuries, and finger injuries.
Call 000 if the seizure lasts more than five minutes, if they do not recover consciousness after it stops, or if it is their first known seizure.
Recovery position after. Once convulsions stop, if the person is unconscious but breathing, place them in the recovery position and monitor until they are fully conscious or help arrives.

Learn how to respond to seizures and other medical emergencies: SKLD Training - check available first aid course dates

Types of Seizures You Might Encounter

Not all seizures look the same. The dramatic full-body convulsion most people picture is one type - but seizures range from brief staring episodes to partial body movements. Understanding the types helps you identify what you are seeing and respond correctly.

Seizure Type	What It Looks Like	First Aid Response
Tonic-clonic (grand mal)	Full body convulsions, rigidity, jerking movements, loss of consciousness, may cry out	Cushion the head, clear area, time the seizure, recovery position after, call 000 if over 5 minutes
Absence (petit mal)	Brief staring, blinking, unresponsive for seconds - looks like daydreaming	Stay with them, guide away from hazards, do not restrain, reassure when they return to awareness
Focal (partial)	One limb or side of body jerking, altered awareness, repetitive movements such as lip-smacking	Guide away from hazards, do not restrain, speak calmly, monitor, call 000 if condition worsens
Atonic (drop attack)	Sudden loss of muscle tone, person collapses without warning	Help them to the ground if possible, cushion the head, check for injury from the fall
Myoclonic	Sudden brief muscle jerks, usually arms or legs, person may remain conscious	Stay with them, guide away from hazards, monitor, call 000 if prolonged or consciousness is lost
Febrile (children)	Triggered by high fever in children under 5 - usually tonic-clonic in appearance	Same as tonic-clonic response, plus cool the child gently after, call 000 if first febrile seizure or lasts over 5 minutes

The most common type you will encounter in a workplace or public setting is tonic-clonic. This guide focuses primarily on that response.

What to Do vs What NOT to Do - Side by Side

The most dangerous first aid mistakes during a seizure are well-documented. This table lays them out clearly.

DO This	DO NOT Do This	Why It Matters
Time the seizure from the start	Guess how long it has been going	Duration determines whether 000 is needed - five minutes is the threshold
Clear hard objects from the area	Move the person unnecessarily	Head and limb injuries during convulsions come from the environment, not the seizure itself
Cushion the head	Hold the head still forcibly	Forced restraint of the head can cause cervical injury; cushioning absorbs impact without force
Stay calm and stay present	Crowd around or call out loudly	Bystanders crowding increases confusion and stress for the person as they recover
Place in recovery position after convulsions stop	Leave them on their back unmonitored	Post-seizure unconsciousness with no airway protection risks airway obstruction from saliva or vomit
Monitor breathing throughout	Assume they are fine once convulsions stop	Post-ictal phase can include confusion, unconsciousness, and irregular breathing - all require monitoring
Speak calmly as they regain consciousness	Ask them questions immediately or demand they focus	Post-ictal confusion is normal - the person is disoriented and needs calm reassurance, not interrogation

When to Call 000 - the Thresholds

Not every seizure requires an ambulance. Knowing the thresholds means you are not calling 000 for every brief episode, but you are also not under-responding to a genuine emergency.

Situation	Call 000?	Notes
Seizure lasts more than 5 minutes	Yes - immediately	Status epilepticus (prolonged seizure) is a medical emergency requiring medication to stop
Person does not regain consciousness after the seizure stops	Yes	Recovery should begin within a few minutes - prolonged unconsciousness is abnormal
Second seizure occurs shortly after the first	Yes	Cluster seizures require medical evaluation
Person is injured during the seizure	Yes	Head injuries, cuts, or fractures from falls need assessment
First known seizure - no prior history	Yes	Underlying cause (tumour, stroke, metabolic cause) must be investigated
Seizure occurs in water	Yes - and remove from water immediately	Drowning risk during and immediately after seizure
Person is pregnant	Yes	Seizure in pregnancy (possible eclampsia) is always a medical emergency
Known epileptic, brief seizure, returns to normal	Not necessarily - follow their care plan if available	Many people with epilepsy have action plans - check if they carry one

If you are unsure, call 000. The ambos would always rather be called and find the person has recovered than arrive to find a preventable death.

What Happens After the Seizure Stops - the Post-Ictal Phase

After a tonic-clonic seizure, the person enters what is called the post-ictal phase. This is not a separate medical event - it is a normal aftermath of the brain's intense activity during the seizure. It can last anywhere from a few minutes to an hour, depending on the individual and the severity of the seizure.

What to expect in the post-ictal phase:

Deep confusion or disorientation - the person may not know where they are, what day it is, or what just happened.
Extreme tiredness or drowsiness - many people want to sleep. This is normal.
Headache - often reported as the brain recovers from the episode.
Nausea or vomiting - the recovery position protects the airway if vomiting occurs.
Temporary weakness on one side - known as Todd's paralysis, this can look alarming but typically resolves within minutes to hours.
Emotional distress - fear, embarrassment, or agitation are common once the person becomes aware of what happened.

Your role during this phase is to stay present, speak calmly and reassuringly, and keep monitoring their breathing. Do not leave them alone. Do not offer food or water until they are fully alert. Do not ask them to walk or stand until you are certain they are oriented and stable.

Seizure First Aid Across Gold Coast Settings

Seizures can occur in any workplace, school, or public space. Gold Coast environments where this response matters include:

Schools and childcare (Robina, Burleigh Heads, Coomera): Children with known epilepsy are required to have an individual care plan. Staff in education settings must know how to follow these plans and respond to unexpected seizures. HLTAID012 covers this in detail.
Hospitality and events (Surfers Paradise, Broadbeach, Southport): High foot traffic, heat, alcohol, and strobe lighting all create environments where seizure triggers are elevated. First aiders in these settings respond to seizures more frequently than in most industries.
Construction and trades (Helensvale, Pimpama, Ormeau): A seizure on a worksite near machinery, edges, or heights is an extreme hazard. Designated first aiders must be able to respond immediately and manage scene safety simultaneously.
Aged care and disability support: Seizures are more prevalent in older adults and people with certain disabilities. Support workers need confident, practised responses, not just theoretical knowledge.
Fitness facilities (Southport, Varsity Lakes): Exercise can be a trigger for some individuals, and gym environments contain hard floors and equipment that create significant injury risk during a seizure.

In all of these settings, the correct response is the same. What differs is the environment you are managing around the person - and that is where trained situational awareness makes a real difference.

Train your team to respond confidently: SKLD Training - onsite and public first aid courses on the Gold Coast

Seizures in the HLTAID011 First Aid Course

Seizure management is covered as part of HLTAID011 Provide First Aid - the standard nationally recognised first aid qualification. The unit includes recognition and response to medical emergencies including seizures, diabetic emergencies, stroke, asthma, and anaphylaxis.

In the course you will:

Work through simulated seizure scenarios where you practise the correct response sequence.
Learn to identify different seizure types and adjust your response accordingly.
Practise the recovery position on a real person, including transitioning from seizure management to post-ictal airway protection.
Understand when to call 000 and what information to relay to the dispatcher.
Learn how to manage bystanders and the immediate environment during and after a seizure.

The competency is assessed practically - you respond to a scenario and demonstrate the correct sequence. It is not a written test. Reading this guide helps you understand the principles, but hands-on practice is what prepares you to act under stress. (HLTAID011 - training.gov.au)

Epilepsy Action Plans

Many people with epilepsy carry a written action plan. If the person has one, find it and follow it. These plans are prepared by the person's neurologist or GP and contain specific instructions tailored to their seizure type, medication, and what to do if the standard response is not sufficient.

Common elements of an epilepsy action plan include:

The person's known seizure types and how they present.
Duration thresholds specific to that person.
Emergency medication instructions (some plans include midazolam or diazepam for rescue therapy).
When to call 000 for that individual, which may differ from the general thresholds.
Contact details for the person's GP, neurologist, or emergency contact.

Do not administer any medication unless you are specifically trained and authorised to do so under a care plan. If in doubt, call 000 and wait for paramedics.

For detailed clinical guidance on epilepsy management, refer to Epilepsy Action Australia.

Frequently Asked Questions

What should you do if someone has a seizure?

Time the seizure, clear hard objects from the area, cushion the person's head with something soft, and stay with them. Do not hold them down, do not put anything in their mouth, and do not try to stop the convulsions. Once convulsions stop, if they are unconscious but breathing, place them in the recovery position. Call 000 if the seizure lasts more than five minutes, if they do not recover consciousness after it stops, if they are injured, or if it is their first known seizure. Speak calmly as they regain consciousness - confusion and tiredness afterward are normal.

Should you hold someone down during a seizure?

No. Holding someone down during a seizure cannot stop it - seizures are caused by abnormal electrical activity in the brain, not by voluntary muscle movement. Attempting to restrain the person risks injuring them (dislocated joints, fractures) and injuring you. The correct approach is to remove hazards from the environment around the person rather than trying to control the person's movements. Cushion the head and let the seizure run its course while you time it and monitor.

When should you call an ambulance for a seizure?

Call 000 if the seizure lasts more than five minutes, if the person does not regain consciousness within a reasonable time after the seizure stops, if a second seizure follows quickly, if the person is injured, if it is their first known seizure, if they are pregnant, or if the seizure occurs in water. For someone with a known epilepsy diagnosis who has a brief seizure and returns to normal, an ambulance may not be necessary - but if you have any doubt, call. A brief call to 000 for guidance costs nothing.

Can someone swallow their tongue during a seizure?

No. It is physically impossible to swallow your tongue. The tongue is attached to the floor of the mouth by the frenulum and cannot be swallowed. This is one of the most persistent myths in first aid, and acting on it by trying to hold the tongue or placing objects in the mouth causes real harm - broken teeth, bitten fingers, jaw injuries, and damage to the airway. The airway risk during a seizure is from vomit or saliva pooling, which is why placing the person in the recovery position after the seizure stops is important.

What do you do after a seizure stops?

If the person is unconscious but breathing, place them in the recovery position - on their side with the head tilted back slightly to keep the airway open and allow fluids to drain. Monitor their breathing continuously. Speak to them calmly as they begin to regain consciousness. Do not offer food or water until they are fully alert. Check for injuries from the seizure. If they have an epilepsy action plan, retrieve it and follow any specific instructions. Call 000 if you have not already and any of the emergency thresholds apply.

How long do seizures usually last?

Most tonic-clonic seizures last between one and three minutes, then stop on their own. Absence seizures typically last only seconds. A seizure lasting more than five minutes is classified as status epilepticus - a medical emergency where the brain cannot self-terminate the seizure. Status epilepticus requires medication from paramedics to stop and can cause brain damage if left untreated. This is why timing from the moment the seizure starts is one of the most important things a first aider can do.

Build the skills to respond when it matters: Book a first aid course with SKLD Training on the Gold Coast

Training and assessment delivered on behalf of Allens Training Pty Ltd RTO 90909.