Seizures – safety issues and how to help

  • It can be scary to see a child having a seizure (also called a fit). It is very helpful to know what to do, how to help and when to call an ambulance. Adults looking after a child who has a seizure disorder (e.g. epilepsy) also need to know what to do to make sure the child is safe.

    If you are present when someone is having a seizure, you should follow the simple first aid instructions below.

    Types of seizures

    Major seizures involve convulsions, which are stiffening and/or jerking movements of the limbs. These seizures are often called convulsive seizures, tonic-clonic seizures, or a fit.

    Some children may have minor seizures where they 'go blank' and stare for a few seconds or minutes. Sometimes they stay fully conscious during a seizure and can describe what happened or how they felt. Sometimes they may simply seem confused or display unusual behaviour. These seizures may also be called absence seizures or focal seizures.

    First aid for seizures

    • Stay calm.
    • Protect the child from injury by moving harmful objects away from them.
    • Begin timing how long the seizure lasts.
    • Check for medical identification e.g. a medical alert necklace or bracelet.
    • Stay with the child and give reassurance.
    • If the child is on the ground, put something soft under their head and loosen anything that is tight around their neck.
    • If the child is having convulsions, do not try to stop them from moving, and do not put anything in their mouth.
    • Try to give them some privacy and keep other people away.
    • If the child is lying down, once the seizure finishes, roll the child onto their side until they are ready to sit themselves up.
    • Consider if an ambulance needs to be called (see below).

    If the seizure happens in a wheelchair, car seat or stroller

    Leave the child seated if they are secure and safely strapped in.

    If they are having convulsions, gently hold their head. When the jerking stops, if they are unconscious, take them out of the seat, lay them down and roll them onto their side.

    When to call an ambulance

    It is not necessary to call an ambulance every time a seizure occurs in a child who has epilepsy. Most people who have epilepsy will recover from their seizure without any problems after a few minutes.

    You should call an ambulance if:

    • you think it is the child's first seizure
    • the seizure lasts more than five minutes
    • another seizure quickly follows the first one 
    • the child remains unconscious or has trouble breathing after the seizure
    • the seizure happens in water
    • the child is hurt or injured
    • the child has diabetes
    • the child does not seem to fully recover.
    • you are about to give medications (e.g. diazepam or midazolam) to stop the seizure, unless your doctor has told you otherwise.

    When to see a doctor

    You should always see a doctor after your child's first seizure, or following a seizure that lasts more than five minutes, even if they make a full recovery.

    After the first seizure, the biggest risk of having another seizure is within the next three months. Your child's doctor will give you advice on any activities your child should not do and for how long. 

    General safety after a seizure

    Here are some recommendations to help keep your child safe if there is a chance they may have another seizure.

    • Develop an action plan with your child's doctor. This plan will provide simple, easy instructions on what to do if a seizure happens.
    • Make sure anyone caring for your child knows what to do in the event of a seizure, and has access to the action plan and any medical kit your child requires.
    • Consider getting your child a medical identification bracelet or necklace to wear.
    • Take care around water. Always make sure your child swims with a supervising adult. This person needs to be able to swim well. Get your child to have showers instead of baths.
    • Always turn on the cold tap before the hot tap and lower the temperature of the hot water service at home to a maximum of 50°C. A plumber can help you do this.
    • Take special care when using hot water or things that can cause burns (e.g. irons, kettles, stoves, barbecues, campfires).
    • Activities involving heights are best avoided unless appropriate support is provided.
    • When riding a bicycle or scooter, in addition to wearing helmets and protective guards, your child should always be accompanied by an adult.

    Key points to remember

    • If a seizure lasts more than five minutes, or you think it is the child's first seizure, call an ambulance.
    • Anyone looking after a child who has a seizure disorder needs to know what to do to make sure the child is safe.
    • Move things away so the child does not hurt themselves, and do not put anything in their mouth.
    • After a first seizure, the biggest risk of having another seizure is in the next three months.

    For more information

    Podcast Image

    Making sense of seizures

    Common questions our doctors are asked

    If my child has had a seizure does this mean he has epilepsy?

    Not necessarily. Epilepsy and seizures are not exactly the same thing. Epilepsy is a condition affecting the brain that means the person has a lower threshold for having a seizure, and they tend to have repeated episodes. Children can have seizures for other reasons, such as febrile convulsions or head injuries. Your doctor will investigate the cause of your child's seizure.

    What else can I do if my child has epilepsy?

    It is wise to purchase a medical alert bracelet to notify others that your child has epilepsy. You should complete a first aid course and ask your child's doctor about specific management during and after seizures. It is important that all teachers and caregivers are familiar with these procedures too.


    Developed by The Royal Children's Hospital Emergency department and Neurology Department. We acknowledge the input of RCH consumers and carers.

    Reviewed June 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.