What to Do When Someone Has a Seizure — and When to Call an Ambulance

During a seizure your job is to stop the person getting hurt, not to stop the seizure: move hard objects away, cushion their head, don't hold them down, put nothing in their mouth and note the time. A seizure with jerking of the whole body usually stops by itself within one to three minutes. When it stops, check their breathing: if it is normal, roll them onto their side; if it is not, call an ambulance and start CPR.

When to see a doctor

Right away, call an ambulance — 999 in the UK, 911 in the US, 112 in the EU:

the seizure lasts longer than 5 minutes, or longer than is usual for this person;
a new seizure starts before they have fully come round, or there are three or more seizures in 24 hours even if they recover in between (NICE, UK);
it is their first seizure, as far as you know;
they are injured, have trouble breathing afterwards or are hard to wake;
the seizure happened in water;
in US guidance (CDC) also: the person is pregnant or has diabetes;
after the jerking stops they do not respond and are not breathing normally — occasional gasps are not normal breathing. Tell the call handler and start CPR as they instruct.

Soon — within days, not months: a first suspected seizure where no ambulance was called, or the person refused one. It still needs a doctor: in the UK, NICE asks for an urgent referral so that a specialist sees the person within two weeks. For someone with known epilepsy, a seizure that was unlike their usual ones, or seizures becoming more frequent, is a reason to contact their doctor or epilepsy team.

Routinely: a person with epilepsy who has no individual care plan should agree one with their doctor — what counts as a usual seizure for them, and when to use an emergency medicine if one is prescribed (NHS; NICE).

What is happening

Why 5 minutes. Most tonic-clonic seizures — the kind with stiffening and jerking of the whole body — last one to three minutes (Epilepsy Action, UK). Under the 2015 definition of the International League Against Epilepsy, one that goes on longer than 5 minutes already counts as status epilepticus: past this point a seizure is unlikely to stop on its own and needs treatment, and after about 30 minutes the risk of lasting harm rises (ILAE). That is why you time it: the call is decided by the clock, not by how frightening it looks.

Why nothing in the mouth. A person cannot swallow their tongue (Epilepsy Society, UK). The jaw often clenches, and they may bite their tongue or cheek; an object does not prevent that. It breaks teeth, injures the helper's fingers, and pieces, blood or saliva can be inhaled (AHA and American Red Cross, 2024). More on the myth: don't put anything in a seizing person's mouth.

Why not hold them down. Every guideline we checked says the same: don't restrain the movements, only keep the head and body from hitting things (NHS, CDC, Epilepsy Society).

What comes after. Confusion, gaps in memory and heavy sleepiness are normal after a tonic-clonic seizure; full recovery can take from hours to several days (Epilepsy Action).

Not every seizure is convulsive. In a focal seizure with impaired awareness a person may fiddle with their clothes, smack their lips or wander about, and may be confused. Don't restrain them; speak calmly and keep dangers out of their way (Epilepsy Society; Epilepsy Action).

When to turn them on their side. UK guidance (NHS, Epilepsy Society, St John Ambulance) says to do it once the jerking has stopped; the US CDC suggests helping a person who is lying down onto their side already during the seizure. We follow the UK version: during the seizure protect the head, afterwards check breathing and then turn.

What to do

During the seizure

Move them only if they are in danger — near a road, a cooker, stairs. Otherwise move hard and sharp objects away from them.
Put something soft and flat under their head, such as a folded jacket; take off their glasses and loosen a tight collar (CDC; NHS).
Note the time it started.
Don't hold them down. Put nothing in their mouth, fingers included.
Don't give rescue breaths while they are seizing (CDC).
In water: support their head so the face stays above the water and shout for a lifeguard (Epilepsy Society). Once they are out, call an ambulance, check breathing and start CPR if needed. See also what to do if someone is drowning.

When it stops

Check breathing. No response and no normal breathing: call, and start CPR as the call handler instructs — basic CPR.
Breathing normally: roll them onto their side in the recovery position, and gently make sure nothing — food, dentures — is blocking the mouth (NHS; Epilepsy Society). Keep watching the breathing.
Stay with them and talk calmly until they are fully aware. Explain what happened and offer to call someone for them (CDC).
Nothing to eat or drink until they have fully recovered (NHS; CDC).
Look for a medical bracelet or card (CDC). To make your own details findable, set up a medical ID on your phone.

When this is not the case

Epilepsy with an agreed plan. Many people with diagnosed epilepsy don't need an ambulance for every seizure; they have a plan agreed with their doctor, sometimes with a prescribed emergency medicine. If there is a plan, follow it; if there is none or you don't know the person, use the rules above (NHS; NICE).
Diabetes. In someone with diabetes, a fit can come from low blood sugar — call an ambulance and see what to do in a diabetic emergency.

Sources

Checked: 27 September 2026