If your client appears to be having a seizure, follow these basic first aid measures*.  Every situation will be different.

If your client appears to be having a a seizure (more specifically, a tonic–clonic seizure), follow these steps. Clients with seizure disorders are more likely to have a seizure if they stop taking their prescribed anticonvulsant medications. If your client has a first-ever seizure, this requires a referral to the client’s primary care provider for medical evaluation. For more information on seizures go to my seizure disorders blog post.

During the seizure:

1. Stay calm. If possible, time the length of the shaking phase of the seizure.

2. Gently place the person on the floor (if possible). If the person is lying on a massage table, allow the person to remain on the table. Some therapists place pillows on the floor around the length of the massage table as a safety measure. Move other objects away to prevent injury.

3. Place a cushion or soft jacket under the person’s head to keep it inclined; this prevents the head from banging the floor during the shaking phase. Roll the person onto his or her side. This will allow saliva to fall out of the mouth instead of blocking the airway, causing the person to choke.

4. Remain with the person until the seizure has ended.

Suggestions on what to do if someone is having a tonic-clonic seizure,.

After the seizure has ended, help the person back to normal awareness by asking a few simple questions, such as what his or her name is and the location. Use a calm and reassuring voice. If possible, place the person in a recovery position. The post-seizure period is called the postictal period and can last from several minutes to several hours.

recovery-position (1)
The recovery position helps keep the airway clear. Do not attempt if you think the person has a spinal injury.

Ensure the client is safe. If he or she has bitten the tongue or cheek, those areas may be sore. If the person experienced incontinence, be sensitive and helpful and provide assistance if needed. The person may feel tired, confused, and have no memory of the event. He or she may also complain of a headache or general muscle soreness.

Call 911 in the following cases:

  • It is the person’s first seizure or if you do not know
  • If the seizure lasts more than 5 minutes or immediately repeats, or if the person cannot be awakened after the seizure
  • If the person is injured or vomits during the seizure
  • If the person has a medical condition such as diabetes, heart disease, congestive heart failure, or is pregnant.
  • Inform EMT’s (emergency medical technicians) how long the seizure has lasted and symptoms exhibited.

caution icon  Things to avoid during or after a seizure are:

  • Do not restrain the person; this may provoke an aggressive response.
  • Do not put anything in the person’s mouth. You may get bitten.
  • Do not give the person water, food, or medicine until the seizure is over and he or she is alert.

* Adapted from the (1) Centers for Disease Control and Prevention, (2) Epilepsy Action, and the (3) Epilepsy Society.

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Articles and Journals Referenced:

  1. Centers for Disease Control and Prevention: Seizure first aid. Available at https://www.cdc.gov/epilepsy/basics/first-aid.htm
  2. Epilepsy Action: What to do when someone has a seizure. Available at https://www.epilepsy.org.uk/info/firstaid
  3. Epilepsy Society: 10 first aid steps. Available at https://www.epilepsysociety.org.uk/10-first-aid-steps-for-convulsive-seizures#.WHy_6fXrsYU


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Dr. Susan Salvo is a massage practitioner, author, educator, researcher, explorer, and perpetual student. To learn more about Susan, check out the “About Susan” tab. You can contact Susan at susansalvo@hotmail.com.