Immediate Steps During a Seizure
Safety First: Protecting the Individual
When an elderly person begins to have a seizure, your primary goal is to ensure their immediate physical safety. Panic can set in quickly, but a calm, focused approach is essential. The first thing you must do is protect them from injury. Look around and move any hard, sharp, or dangerous objects away from them. This includes furniture corners, glass, or other items they might hit during convulsive movements. If they wear glasses, remove them gently to prevent a potential injury to their face or eyes.
After clearing the area, gently guide the person to the floor if they are standing or in a chair. Do not try to stop their movements or hold them down. Restraining a person can cause fractures or other musculoskeletal injuries. Instead, place something soft and flat under their head, such as a folded jacket, pillow, or towel. This cushions their head from repeated impact with the floor. Loosen any tight clothing around their neck to aid breathing.
The Recovery Position: A Crucial Action
Once the active convulsions have stopped, it is time to perform the recovery position. This is a critical step, especially in older adults, to prevent aspiration. Aspiration occurs when saliva or vomit enters the lungs, which can lead to serious respiratory complications like pneumonia.
How to Place Someone in the Recovery Position
- Gently roll the person onto one side. Their mouth should be facing toward the ground to allow fluids to drain naturally from their mouth and not into their throat.
- Angle their head slightly backward to further open the airway.
- Monitor their breathing carefully. While it might sound like they have stopped breathing during a convulsive seizure, breathing usually resumes on its own once the seizure is over. Wait for normal breathing to return before proceeding.
What NOT to Do During a Seizure
There are several common misconceptions about what to do during a seizure that can be harmful. Avoiding these actions is as important as knowing what to do.
- Do not put anything in their mouth. It is impossible to swallow one's tongue during a seizure. Placing a spoon, wallet, or your fingers in their mouth can cause serious injury to their teeth, jaws, and your hands. The item can also become a choking hazard.
- Do not restrain their movements. Holding them down or trying to stop the shaking will not end the seizure and can cause harm.
- Do not give food, drink, or medication by mouth until the person is fully awake and alert. They are not able to swallow properly during or immediately after a seizure, and this could cause them to choke.
Seizure Timing and When to Call 911
Timing the seizure is vital information for medical professionals. Most seizures last less than five minutes. Use a watch or phone to note when the seizure starts and ends. This information can help a doctor determine the best course of action.
When to Seek Emergency Medical Attention
While most seizures are not life-threatening and end on their own, certain situations require immediate emergency care. Call 911 or your local emergency number if:
- The seizure lasts longer than five minutes. A seizure lasting this long is considered a medical emergency and needs intervention.
- It is their first seizure. A first-time seizure requires a full medical evaluation to determine the cause.
- A second seizure begins before the person has fully recovered from the first.
- The person was injured during the seizure.
- The person is having trouble breathing or waking up after the seizure has ended.
- The seizure occurred in water (e.g., in a bathtub or swimming pool).
- The person has known health conditions like diabetes, heart disease, or is pregnant.
Post-Seizure Care and Observation
After the seizure is over and the person is in the recovery position, stay with them until they are fully conscious and alert. An elderly person may be confused, disoriented, or sleepy. Speak to them calmly and reassuringly, explaining what happened. Offer a blanket if they seem cold.
If the elderly person has a known seizure disorder, their doctor or family may have provided instructions on a seizure action plan. This might include administering a rescue medication. Ensure you are familiar with these instructions if you are a regular caregiver.
Comparing Seizure Types and First-Aid Actions
Caring for an elderly person with a seizure can vary slightly depending on the type of seizure. Here is a comparison of common seizure types and recommended actions.
| Feature | Tonic-Clonic (Grand Mal) | Absence (Petit Mal) | Focal Impaired Awareness | Post-Seizure State |
|---|---|---|---|---|
| During Seizure | Body stiffens, then jerks convulses. | Stares blankly, brief loss of awareness. | Confused, repetitive movements. | Postictal (confusion, fatigue). |
| First Aid | Clear area, cushion head, turn on side. | No direct first aid needed. | Gently guide away from danger, speak calmly. | Postictal state (confusion). |
| After Seizure | Observe breathing, offer reassurance. | Normal alertness returns quickly. | Guide and reassure until fully alert. | Normal alertness returns quickly. |
| Call 911 | If > 5 min, first time, injury, etc. | If multiple episodes occur back-to-back. | If it lasts longer than usual or injury occurs. | If trouble breathing or doesn't wake up. |
For more in-depth information and training on how to assist during a seizure, please consult the Epilepsy Foundation's resources at https://www.epilepsy.com.
Conclusion
Understanding what to do when an elderly person is having a seizure is a critical skill for caregivers and family members. Your actions, or lack thereof, during this brief but intense medical event can significantly impact the outcome. The key is to remember the core principles of first aid: ensure safety by protecting them from harm, maintain an open airway by placing them in the recovery position, and know when to seek emergency medical help. By staying calm and following these steps, you can provide the best possible care during a seizure, protecting your loved one's health and well-being.
