Seizures in Adults: First Aid Steps and Myths to Stop Believing
Almost everything films taught us about seizures is wrong. You can’t swallow your tongue, and holding someone down can injure them. Here is what actually helps.
When an adult has a convulsive seizure: (1) note the time it starts; (2) clear hard objects away and cushion the head; (3) do not restrain them and do not put anything in their mouth; (4) when the jerking stops, roll them into the recovery position on their side. Call 911 if the seizure lasts longer than 5 minutes, a second one starts before they wake, they don’t return to normal within 5–10 minutes, it’s their first seizure, it happened in water, or they’re injured, struggling to breathe, or pregnant.
The Myths — and the Truth
Myth: “Put a wallet or spoon in their mouth so they don’t swallow their tongue.”
Truth: It is physically impossible to swallow your tongue. Forcing an object — or your fingers — into the mouth of a seizing person can break their teeth, dislocate their jaw, block their airway, or result in a severe bite to your hand. Never put anything in the mouth.
Source: American Heart Association & American Red Cross First Aid Guidelines 2024 (nothing in the mouth — listed as an action that causes harm).
Myth: “Hold them down to stop the shaking.”
Truth: You cannot stop a seizure by restraining someone, and trying to can tear muscles, strain joints, or break bones — both theirs and yours. The convulsions are driven by the brain’s own electrical activity, not by anything you can hold down, so restraining never shortens a seizure. Let the seizure happen and focus on clearing hazards from around them.
Source: AHA & American Red Cross 2024 (do not restrain — listed as an action that causes harm).
Myth: “Give them water or medication during the seizure.”
Truth: Never give food, drink, or pills to someone who is seizing or not fully conscious afterward. They cannot swallow safely and could choke.
Source: AHA & American Red Cross 2024 (no food, liquid, or oral medication during or after a seizure while responsiveness is reduced).
Myth: “A seizure means epilepsy and an ambulance.”
Truth: Many people with epilepsy have brief seizures that stop on their own and do not need 911. A seizure is self-limiting — it usually runs its course in one to three minutes and then stops by itself. An ambulance is needed only when specific red flags appear (listed below).
Source: Canadian Red Cross; AHA & American Red Cross 2024.
Step-by-Step: First Aid for a Convulsive Seizure
This applies to a tonic-clonic seizure — the type where a person loses consciousness, stiffens, and has rhythmic jerking.
1Note the time it starts
Check a clock or start a timer the instant the seizure begins. The 5-minute mark is the key decision point for calling 911 — a seizure past that point is called status epilepticus and is a medical emergency. Seizures almost always feel longer than they are, so accurate timing is genuinely lifesaving information.
2Clear the area and protect them
Move away furniture, hard objects, hot drinks, and anything sharp. If they are near a road, water, or stairs, gently guide them away from danger if you safely can. Place something soft — a folded jacket, a cushion — under their head, and remove glasses and loosen anything tight around the neck.
3Do not restrain them, do not touch their mouth
Let the movements happen. Do not hold them down and do not put anything between their teeth. Your job is to keep the space around them safe, not to stop the seizure.
4When the jerking stops, roll them onto their side
Once the convulsions end, gently place the person in the recovery position — on their side, with the head tilted slightly back and the top knee bent for stability. This keeps the airway open and lets saliva or vomit drain out instead of being inhaled.
5Stay with them and reassure them
After a seizure, people are often confused, exhausted, embarrassed, or upset — this recovery (post-ictal) phase can last many minutes. Stay calm, speak gently, tell them what happened, and stay until they are fully alert and back to their normal self. Protect their dignity, especially in public.
6If they are not breathing normally — begin CPR
It is uncommon, but if after the seizure the person is unresponsive and not breathing or only gasping, call 911 and start CPR immediately. Knowing how means you will act instead of freeze — every Life Safe course includes hands-on CPR practice.
Source: American Heart Association & American Red Cross First Aid Guidelines 2024; Canadian Red Cross (protect from injury, recovery position, stay with the person).
When to Call 911 for a Seizure
Call 911 if:
- The seizure lasts longer than 5 minutes
- A second seizure begins before the person wakes up from the first
- The person does not return to normal within 5–10 minutes, or does not regain consciousness or normal breathing after the seizure ends
- It is their first-ever seizure, or you do not know their history
- The seizure happened in water
- The person is injured, is having trouble breathing or choking, is pregnant, or has diabetes
- You have any doubt about whether help is needed
Source: American Heart Association & American Red Cross First Aid Guidelines 2024 (EMS activation criteria for seizures).
Not All Seizures Look Like Convulsions
Some seizures are subtle. A person may suddenly stare blankly, become unresponsive for a short time, make repetitive movements like lip-smacking or fidgeting, wander, or seem confused and unaware of their surroundings. During these, gently guide them away from danger, speak calmly, do not grab or restrain them, and stay with them until they are fully aware again. The same rule applies: call 911 if it is prolonged, repeated, or their first.
Help Without Fear
Most people freeze during a seizure because they are afraid of doing the wrong thing — and the myths make it worse. Learning the real steps, and practising the recovery position with your own hands, removes that fear. A Life Safe first aid course covers seizure response, the recovery position, and CPR, so you can step in calmly and correctly when it counts.
Frequently Asked Questions
What should you do when someone is having a seizure?
Stay calm and note the time. Clear hard objects away and cushion their head. Do not restrain them and do not put anything in their mouth. When the jerking stops, roll them onto their side into the recovery position. Stay with them as they recover, and call 911 if it lasts over 5 minutes, repeats without them waking, or is their first seizure (Canadian Red Cross / AHA 2024).
Should you put something in a seizing person’s mouth?
No — never. A person cannot swallow their tongue. Forcing a spoon, wallet, or fingers into the mouth can break teeth, damage the jaw, block the airway, or get you badly bitten. Leave the mouth alone and focus on protecting the head and turning them on their side afterward (AHA 2024).
When should you call 911 for a seizure?
Call 911 if the seizure lasts over 5 minutes, a second follows before they wake, the person does not return to normal within 5–10 minutes, it is their first seizure, it happened in water, they are injured, having trouble breathing, choking, pregnant, or diabetic, or you are unsure. Many people with epilepsy have brief seizures that do not need an ambulance, but any red flag means call (Canadian Red Cross / AHA 2024).
Should you hold someone down during a seizure?
No. Never restrain someone having a seizure. You cannot stop the movements, and forcing the body still can cause muscle, joint, or bone injuries to them and to you (AHA 2024 lists restraint as an action that causes harm). Instead, clear the area, cushion their head, and let the seizure run its course.
Replace Panic With Practised Confidence
The difference between freezing and helping is training. Life Safe’s hands-on first aid and CPR courses teach you the real, evidence-based response to seizures and other medical emergencies — no myths, just skills that work.
Find a class near you: Toronto • Downtown Toronto • East York • Hamilton • Welland • Guelph
Sources & medical review
Reviewed by Milos Radojcic (Canadian Red Cross / Heart & Stroke / Lifesaving Society First Aid & CPR Instructor, 10+ yrs). Clinical content aligned with the American Heart Association & American Red Cross First Aid Guidelines 2024 (seizure first aid: protect from injury, recovery position, do not restrain, nothing in the mouth, EMS-activation criteria) and the Canadian Red Cross. Last reviewed July 2026.