Emergency Response
When a seizure becomes an emergency, knowing what to do matters
This information is for guidance only and does not replace medical advice, education, first aid courses, emergency care, or your child’s individualized seizure action plan from their healthcare team
This guide helps families, caregivers, teachers, support workers, and loved ones understand what to do during a seizure, when to follow a rescue plan, and when emergency help is needed.
Not all seizures are medical emergencies, however they can become an emergency if it is the persons first one, last too long, happen back to back, affect breathing, cause injury, or recovery does not look normal. Knowing the difference helps people respond with calm, confidence, and urgency when it matters most.
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If you witness a seizure and feel uncomfortable, unsure, or nervous, call for help
Stay and time it
Stay with the person and start timing the seizure from the beginning. Timing matters because seizure length helps determine whether emergency help or rescue medication may be needed
Protect breathing
If the person is lying down, gently turn them onto their side to avoid them inhaling fluids or experiencing a compromised airway position, when it is safe to do so. Watch their breathing, color, and whether they are recovering normally
What To Do During a Seizure
The first priority is safety. Stay with the person, gently turn them on their side (if they are lying down), time the seizure, protect them from injury, check for medical ID, and watch their breathing and recovery. Do not hold them down and do not put anything in their mouth
Make the area safe
Move hard, sharp, or dangerous objects away. Protect the person from injury without restraining their body or trying to stop the seizure
Do not put anything in their mouth
Do not put food, drink, fingers, or objects in the person’s mouth, this can cause serious injury. Do not try to force the seizure to stop
Back-to-back seizures
Call for help if another seizure starts before the person has recovered from the first one
Injury, water, or first seizure
Emergency help is needed if the person is injured, the seizure happened in water, or this is their first known seizure
When a Seizure Becomes an Emergency
A seizure may need urgent medical help if it lasts too long, happens repeatedly, causes injury, happens in water, affects breathing, or the person does not recover normally
Long seizure
A seizure lasting around 5 minutes or longer require a call for emergency help, unless the person’s written plan says otherwise.
Heart or circulation concerns
A concerning heart rate pattern, collapse, poor color, or signs that circulation is not recovering should be treated as urgent
Breathing problems
Breathing that does not return to normal, blue or gray color, severe oxygen drops, or unusual breathing after the seizure needs urgent attention
Not returning to baseline
If the person does not wake, respond, breathe, or recover the way they normally do, follow the emergency plan and get help
Where Rescue Medication Fits
Some people are prescribed rescue medication for prolonged seizures or seizure clusters. Rescue medication should be part of a written seizure action plan that explains when to give it, how much to give, how to give it, and when to call emergency help
Rescue medication plans should be clear before an emergency happens
What medication is prescribed?
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What dose should be given?
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What route is used?
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What seizure length, seizure cluster, or symptom triggers its use?
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When should emergency services be called?
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What should caregivers watch for after it is given?
Caregiver(s) must know
Where the medication is kept?
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How to give it?
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When to give it?
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What side effects to watch for?
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When to call emergency help?
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Who to notify afterward?
Breathing
Is breathing regular, strong, and returning to normal?
The Seizure Ending Is Not Always the End of The Emergency
Responsiveness
Are they gradually waking or responding the way they usually do after a seizure?
Visible seizure activity can stop before the body has fully recovered. After a seizure, watch: breathing, color, responsiveness, position, oxygen (if monitored), heart rate pattern, and whether the person returns to their usual baseline
Oxygen & heart rate
If monitored, are oxygen levels and heart rate returning toward that person’s normal range?
Position
Are they in a safe position with their airway clear?
Color
Is color improving, or is the person still blue, gray, pale, or dusky?
Every High-Risk Seizure Plan Should be Written Down
A seizure action plan makes emergency response easier because no one has to guess under pressure. It should be specific to the person, easy to read, and available wherever care happens: home, school, respite, daycare, hospital bag, and caregiver instructions
Action Plans Should Include:
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Seizure type and usual pattern
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What the seizure usually looks like
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When to start timing
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What counts as the "beginning"
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When to use rescue medication
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Exact timing, seizure cluster instructions, and route
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When to call emergency services
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Clear red flags
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What to check after the seizure: breathing, color, oxygen, heart rate, responsiveness, and baseline recovery
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Who to contact afterward: parent, guardian, neurologist, nursing team, school, or emergency contact.
Breathing and Recovery Deserve Special Attention
For some people, the most dangerous part of a seizure is not only the visible seizure itself. It may be what happens during or after: breathing pauses, oxygen drops, color change, slow recovery, or a heart rate pattern that does not return to normal. These signs should be written clearly into the emergency plan so caregivers know when a seizure is no longer routine
If breathing is not normal, do not wait!
If breathing is absent, severely abnormal, or not recovering after the seizure, follow the emergency plan and call emergency services. If the care team has given specific oxygen, positioning, suction, rescue medication, or ventilation instructions, those should be written clearly and practiced with caregivers