Seizure First Aid: How to Handle a Tonic-Clonic Epileptic Episode

When someone experiences an epileptic seizure, particularly a tonic-clonic episode, it's crucial to respond appropriately to ensure their safety. Tonic-clonic seizures, previously referred to as grand mal seizures, are among the most intense types of epileptic episodes and often involve a sudden loss of consciousness followed by violent muscle contractions.

Understanding the Nature of the Seizure

During a seizure, individuals may fall backward or forward depending on their posture at the onset. Falling backward is more common, which can pose a significant risk if there are sharp or hard objects behind the person. Injuries such as head trauma or even puncture wounds from sharp objects are possible, including damage to the lungs or muscles if a person falls onto a pointed surface.

Immediate Actions to Take

The first priority is to protect the person's head and clear the surrounding area of any potential hazards. Gently support their head if possible and move objects away to prevent injury. Do not attempt to restrain the person or put anything in their mouth, as this can lead to further harm.

Maintaining Airway Patency

One of the most critical aspects of seizure first aid is ensuring the person can breathe properly. During the tonic phase, the muscles stiffen, followed by the clonic phase where jerking movements occur. After the seizure subsides, the person may enter a post-seizure drowsy or confused state known as the postictal phase.

When to Seek Emergency Help

If the person does not regain consciousness between seizures or has repeated seizures without regaining awareness, it could indicate status epilepticus—a life-threatening condition requiring immediate medical attention. Seizures lasting more than five minutes also warrant urgent hospitalization. In such cases, calling emergency services is essential to prevent long-term complications or even death.

Post-Seizure Care

Once the seizure ends, help the person into a recovery position and stay with them until they fully recover. Offer reassurance and monitor their breathing. If it's the person's first seizure or if they appear injured, seek medical evaluation as soon as possible.