Seizures in adults

 Recovery position

A seizure – also called a convulsion or fit – consists of involuntary contractions of many muscles in the body.

The condition is due to a disturbance in the electrical activity of the brain. Seizures usually result in loss or impairment of consciousness.

The most common cause is epilepsy. Other causes include:

  • Head injury
  • Some brain damaging diseases
  • Shortage of oxygen or glucose in the brain
  • The intake of certain poisons including alcohol.

Epileptic seizures are due to recurrent, major disturbances of brain activity. These seizures can be sudden and dramatic. Just before a seizure, a casualty may have a brief warning period (aura) with, for example, a strange feeling or a special smell or taste.

No matter what the cause of the seizure, care must always include maintaining an open, clear airway and monitoring the casualty's vital signs – breathing, level of response and pulse. You will also need to protect the casualty from further harm during a seizure and arrange appropriate aftercare once they have recovered.

Recognition features

  • Sudden loss of consciousness
  • Casualty goes rigid, arching their back
  • Breathing may become noisy and difficult
  • Convulsions begin (jerky movements)
  • Saliva from the mouth can be blood stained if they have bitten their lips or tongue
  • Loss of bladder and bowel control
  • They relax, breathing becomes normal and they recover consciousness within a few minutes
  • They may be unaware of their surroundings and feel very tired
  • They can fall into a deep sleep.

Your aims

  • To protect the casualty from injury
  • To give care when consciousness is regained
  • To arrange removal of the casualty to hospital if necessary.

Treatment

  • If you see the casualty falling, try to ease the fall
  • Make space around them; ask bystanders to move away
  • Remove potentially dangerous items, such as hot drinks and sharp objects
  • Note the time when the seizure started
  • If possible, protect the casualty's head by placing soft padding underneath it
  • Loosen clothing around the neck.

When the seizure has ceased

  • Open the airway and check breathing
  • Be prepared to give rescue breaths and chest compressions
  • Place them into the recovery position if the casualty is unconscious but breathing normally
  • Monitor and record vital signs – breathing, level of response and pulse
  • Note the duration of the seizure.

Caution

  • Do not move the casualty unless they are in immediate danger
  • Do not put anything in their mouth or use force to restrain them.

Warning

If any of the following apply, dial 999 for an ambulance.

  • The casualty is unconscious for more than 10 minutes
  • The seizure continues for more than 5 minutes
  • The casualty is having repeated seizures or having their first seizure
  • The casualty is not aware of any reason for the seizure.

Related topics

Please note:

These hints are no substitute for thorough knowledge of first aid! St John Ambulance holds first aid courses throughout the country.

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