What is the first aid for a child having a seizure?

First Aid for a Child Having a Seizure

Immediately help the child to the ground to prevent fall injuries, place them on their side in the recovery position, clear the surrounding area of dangerous objects, and stay with them throughout the seizure without restraining them or putting anything in their mouth. 1, 2

Immediate Protective Actions

Positioning and Environmental Safety

• Lower the child to the ground immediately to prevent traumatic injuries from falling, which are a major source of morbidity in seizure patients 2
• Place the child on their side in the recovery position to reduce aspiration risk if vomiting occurs during the seizure or postictal period 1, 2
• Clear the area around the child of any objects (furniture, sharp items, hard surfaces) that could cause injury during seizure movements 2
• Stay with the child continuously throughout the entire episode to monitor for complications and provide ongoing protection 2

Critical Actions to AVOID

These are common mistakes that can cause harm:

• Never restrain the child during seizure movements, as this can cause musculoskeletal injuries and does not stop seizure activity 1, 2
• Never put anything in the child's mouth (fingers, bite blocks, tongue blades, spoons) as this can cause dental trauma, airway obstruction, or injury to the rescuer 1, 2
• Never give food, liquids, or oral medicines during the seizure or when the child has decreased responsiveness afterward due to high aspiration risk 1, 2

When to Call Emergency Services

Activate emergency medical services (call 911) if any of the following occur:

• Seizure lasting more than 5 minutes, as these may not stop spontaneously and require emergency anticonvulsant medications 1, 2
• First-time seizure in the child, which requires evaluation for underlying causes 1, 2
• Multiple seizures without return to baseline mental status between episodes 1, 2
• Seizure with traumatic injury (head injury, significant bleeding, suspected fractures) 1, 3
• Child does not return to baseline within 5-10 minutes after the seizure stops 1
• Seizure in an infant younger than 6 months of age 1
• Seizure occurring in water 1
• Seizure with choking or difficulty breathing 1

Important Considerations for Children

Febrile Seizures

• Do not give fever-reducing medications (acetaminophen, ibuprofen, paracetamol) during or immediately after a seizure, as they are not effective for stopping seizures or preventing subsequent febrile seizures 1, 2
• Fever treatment may help the child feel better later but will not prevent seizures 1

Post-Seizure Care

• Most seizures are self-limited and resolve spontaneously within 1-2 minutes 1
• Keep the child in the recovery position until they are fully awake and responsive 2
• Monitor breathing and responsiveness continuously 2

Common Pitfalls to Avoid

The most dangerous misconceptions include attempting to hold the child down (causes injury), forcing objects into the mouth (causes airway trauma), or giving oral medications during impaired consciousness (causes aspiration) 1, 2, 4. Many caregivers and even healthcare professionals harbor these misconceptions, highlighting the critical need for proper seizure first aid education 5, 4.