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Paediatric seizures and febrile convulsions
What is paediatric seizures and febrile convulsions?
Seizures in children range from brief febrile convulsions linked to fever through to prolonged or recurrent fits in epilepsy or serious illness. To a bystander they can look frightening, but the first aider’s job is to keep the child safe, protect the airway, monitor breathing and decide when an ambulance is needed rather than to stop the seizure directly.
Understanding that seizures are a symptom, not a diagnosis, helps first aiders stay calm and focus on practical priorities such as timing the event and looking for red flags. Seizures triggered by fever, infection, head injury or underlying epilepsy that last more than a few minutes, recur in quick succession or are associated with breathing problems or prolonged reduced responsiveness must be treated as medical emergencies and escalated promptly.
UK guidance on gastroenteritis and serious infection warns that fits or convulsions in a child are a red-flag symptom that should prompt urgent medical assessment, reflecting the expectation that any first seizure or prolonged convulsion is treated as an emergency.
Who needs this skill?
Health & Social Care
In health and social care settings, staff supporting children with known epilepsy, learning disability, complex needs or palliative care must be confident in observing different seizure types, following individual care plans, positioning children safely and escalating promptly when episodes are atypical, prolonged or clustered. Documentation and adherence to plans are critical when incidents are later reviewed.Licensed venues & nightlife
Licensed venues and youth events may see seizures triggered by underlying epilepsy, substances or flashing lights; staff must strike a balance between crowd control, the child's privacy and timely medical help, and be prepared to explain their actions afterward.Schools
Schools and early years providers often know which pupils have seizure care plans; staff must understand those plans, supervise safely after any convulsion and recognise when a seizure pattern is different enough to justify emergency care rather than routine follow-up.Workplaces
In workplaces and leisure venues serving families, first aiders may be the first to see a febrile seizure in a previously well child; they need to protect the child from injury, maintain privacy and dignity, and make an early decision about 999 versus urgent GP or 111 depending on duration and recovery.How to manage paediatric seizures and febrile convulsions
- 1Protect the child from injuryNote the start time, move nearby objects away, cushion the head with something soft and loosen tight clothing around the neck. Do not restrain the child's movements or put anything in their mouth; focus on creating a safe space until the seizure stops naturally.Preventing secondary injury during a seizure is a core first aid priority; attempts to hold the child down or force objects between the teeth can cause harm without stopping the fit.
- 2Maintain airway and check breathing once movements stopAs soon as jerking stops, quickly open the airway, check breathing and put the child into the recovery position if they are still unresponsive but breathing normally. If they are not breathing or breathing is not normal, start paediatric CPR and send someone to fetch an AED.Qualsafe's outcomes link seizure management directly to airway, breathing and recovery position skills; breathing checks and recovery positioning are mandatory elements of the paediatric assessment.
- 3Control the environment and reassure othersAsk bystanders to step back to give space and privacy, but keep 1 or 2 helpers nearby; reduce noise and bright lights if possible. As the child starts to recover, speak calmly, explain what happened in simple terms and keep them lying down until they are fully aware and able to sit safely.A calmer environment lowers the child's distress on waking and reduces the risk of injury from confused movements; it also helps staff observe breathing and colour without distraction.
- 4Decide when to call 999 and when to seek adviceCall 999 if the seizure lasts more than 5 minutes, if there are repeated seizures without full recovery between, if breathing or colour is worrying, or if it is the child's first known seizure. For brief, typical febrile convulsions with full recovery, follow local guidance and consider GP or 111 advice, especially for very young infants or if parents are concerned.Clear time-based thresholds for 999 versus advice lines help staff act defensibly rather than guessing based on how 'dramatic' the seizure looked.
- 5Observe, document and hand overStay with the child until fully recovered or the ambulance arrives; note duration, movements, colour, any injuries, and what preceded the event (fever, upset, activity). Share these observations and any existing seizure plan with clinicians and record the incident according to your organisation's policy.Accurate observation and documentation make later clinical decisions and any safeguarding or governance review much more robust.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
Qualifying courses
Qualsafe Level 3 Award in Paediatric First Aid (RQF)
2 days
3 years
Qualsafe Level 3 Award in First Aid at Work (RQF) & Qualsafe Level 3 Award in Paediatric First Aid (RQF) - Combined
3 days
3 years
Common questions
Practical answers for employers, venue managers, and healthcare teams about paediatric seizures and febrile convulsions training.
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You should call 999 if a seizure lasts more than 5 minutes, if seizures repeat without full recovery, if it is the child’s first known seizure, if breathing seems compromised or if you are worried about injury or underlying illness. Short, typical febrile convulsions with full recovery may be managed with urgent GP or 111 advice depending on local guidance.
Febrile convulsions are usually brief, generalised seizures triggered by fever in otherwise healthy young children; epilepsy involves a tendency to recurrent unprovoked seizures and is a medical diagnosis. First aid management is similar in the moment: keep the child safe, check breathing and escalate appropriately.