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Seizures and epilepsy
What is seizures & epilepsy?
A seizure is caused by sudden, uncontrolled electrical activity in the brain; it may involve loss of consciousness, stiffness and rhythmic jerking (tonic-clonic seizure) or more subtle changes in awareness, movement or behaviour. First aid focuses on protecting the person from injury, timing the seizure and supporting recovery, not trying to stop the movements.
Most brief seizures are self-limiting and do not require hospital treatment, but prolonged seizures, repeated seizures without full recovery in between, or seizures in people without a known history of epilepsy can be life-threatening and require urgent medical help. First aiders must also consider other causes of seizure-like activity, such as hypoglycaemia, head injury or intoxication.
Epilepsy is a condition where people have a tendency to have recurrent, unprovoked seizures, affecting around 1 in 100 people in the UK. Many seizures stop on their own within a few minutes but can be frightening to witness.
Who needs this skill?
Health & Social Care
In health and social care, seizures are common in residents and patients with neurological conditions, learning disabilities, brain injuries or dementia, and services should have individual care plans and rescue medication protocols for those at higher risk. Staff must also recognise when a seizure represents a change from someone's usual pattern or may be due to acute illness such as infection or stroke and escalate appropriately.Licensed venues & nightlife
In nightlife and licensed venues, seizures may be related to epilepsy, recreational drugs, alcohol withdrawal, head injury or acute illness; staff must manage crowd safety, protect the person from harm and avoid mislabelling seizures as 'drunkenness' or behavioural issues.Schools
Schools and academies support many pupils with epilepsy and related conditions, so confidence in seizure first aid and individual healthcare plans is essential for safe inclusion on trips, in PE and in the classroom.Workplaces
In workplaces, first aiders may encounter seizures in staff, contractors or visitors with known epilepsy, but also in people with no previous history, where prompt first aid and calling 999 is essential. Employers should allow employees with epilepsy to share care plans if they choose and consider reasonable adjustments to reduce seizure risk in line with equality duties.How to manage seizures & epilepsy
- 1Protect from injury, do not restrainIf someone has a convulsive seizure, move nearby objects out of the way, cushion their head with something soft and remove glasses or sharp items, but do not restrain their movements or put anything in their mouth.Time the seizure from the start and note what you see, as this information is valuable for clinicians.
- 2Maintain airway and privacyOnce jerking stops, open the airway and check breathing; if they are breathing normally and have no obvious injuries that prevent movement, place them in the recovery position and loosen any tight clothing around the neck.Protect their dignity by shielding them from onlookers where possible while still maintaining observation and safety.
- 3Know when to call 999Call an ambulance if the seizure lasts more than 5 minutes, if they have repeated seizures without regaining full consciousness, if this is their first known seizure, if they are injured, pregnant, or if you have any doubt about their recovery.For people with known epilepsy, follow their care plan regarding when to use rescue medication and when to call for emergency help.
- 4Support recoveryStay with the person as they regain consciousness; they may be confused, tired or upset and may not remember the seizure, so explain calmly what happened and discourage them from getting up too quickly.Do not give food or drink until you are sure they are fully awake and swallowing safely, and arrange for someone to accompany them home or to hospital if needed.
- 5Consider possible triggers and causesIf safe and appropriate, gather information from friends, family or witnesses about recent missed medications, drugs, alcohol, sleep deprivation, illness or head injury that might explain the seizure, and pass this on to ambulance crews or clinicians.Document the event clearly in workplace or care records, including duration, features and any injuries, to inform future care and risk assessments.
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
Common questions
Practical answers for employers, venue managers, and healthcare teams about seizures & epilepsy training.
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A convulsive seizure lasting more than 5 minutes, repeated seizures without full recovery, a first-ever seizure, a seizure following head injury or in pregnancy, or any seizure where the person does not regain normal breathing or consciousness afterwards, should all be treated as medical emergencies. In these cases, call 999 immediately.
From a first aid perspective, the priorities of protecting the person, checking airway and breathing, and calling for help if you are concerned are appropriate for both seizures and many other collapse causes. It is safer to treat an event as potentially serious and seek advice than to dismiss worrying signs.