Tonic-clonic seizure first aid

Tonic-clonic seizures used to be called grand mal seizures. Some people with epilepsy still use this term.

Tonic-clonic seizures are the type of seizure most people recognise.

Someone having a tonic-clonic seizure goes stiff, loses consciousness, falls to the floor and begins to jerk or convulse. They may go blue around the mouth due to irregular breathing. Sometimes they may lose control of their bladder or bowels, and bite their tongue or the inside of their mouth.

The seizure is over when the jerking has stopped, the person’s muscles have relaxed and their breathing has returned to normal.

How to help

Do:

• Protect the person from injury (remove harmful objects from nearby)
• Cushion their head with something soft like a cushion, coat or jumper
• Time how long the seizure lasts. Seizures that last longer than 5 minutes can be dangerous
• Look for an epilepsy identity card or identity jewellery – it may give you information about their seizures and what to do
• Aid breathing by gently placing them in the recovery position once their muscles have relaxed
• Stay with them until they are fully recovered
• Be calmly reassuring

Don’t:

• Don’t restrain their movements
• Don’t put anything in their mouth
• Don’t try to move them unless they are in danger
• Don’t give them anything to eat or drink until they are fully recovered
• Don’t attempt to bring them round

A tonic-clonic seizure isn’t usually a medical emergency and you may not need to call an ambulance.

• You know it is their first seizure
• The seizure continues for more than 5 minutes
• They have one tonic-clonic seizure after another without regaining consciousness between seizures
• They are seriously injured during the seizure
• They have trouble breathing after the seizure has stopped

Here’s a reminder of the steps to put someone in the recovery position

1. Put the arm nearest to you at a right angle to the body
2. Bring the other arm across the person’s chest and tuck their hand under their cheek
3. Bring the knee furthest away from you into a right angle, so the foot is flat on the floor
4. Pull on the knee, rolling the person towards you onto their side, whilst protecting their head with the other hand
5. Adjust the top leg so that it’s at a right angle and the person can’t roll onto their back
6. Tilt their head back slightly to keep their airway open
7. Stay with them until they are fully recovered

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