Self-Care at Home
Your initial efforts should be directed first at protecting the child from additionally injuring themselves.
- Help the child to lie down on their side, preferably in a flat, non-crowded area. This will help prevent the child from inhaling any possible vomit which can lead to aspiration pneumonia.
- Remove glasses or other harmful objects in the area.
- Do not try to put anything in the child's mouth to try to stop the seizure; you may injure the child or yourself.
- Immediately check to see if the child is breathing, and continue observing the child for breathing both during and after the seizure. Call 911 immediately to obtain medical assistance if the child is not breathing or looks blue at any time.
- If your child is not breathing within 1 minute after the seizure stops, start mouth-to-mouth rescue breathing (CPR). Do not try to do rescue breathing for the child during a convulsive seizure, because you may injure the child or yourself.
- After the seizure ends, place the child on one side and stay with the child until they are fully awake.
- If the child has a fever, acetaminophen (such as Tylenol) may be given rectally.
- Do not try to give food, liquid, or medications by mouth to a child who has just had a seizure. Unless the child is fully awake and alert, there is a danger of the child inhaling any food, medication or liquid.
- Children with known epilepsy (a history of seizures) should also be prevented from further injury by moving away solid objects in the area of the child. Talk to your doctor about a seizure action plan that has rescue medications.
- If the child is in a boat or near the water they should always have a life jacket on. You should also restrain the child to prevent drowning.
- If you have discussed the use of rectal medication with your child's doctor, give the child the correct dose as directed, if the seizure lasts more than 5 minutes.
- Call 911 if you ever need to administer rectal medication to stop the seizure.
Treatment of children with seizures is different than treatment for adults. Unless a specific cause is found, most children with first-time seizures will not be placed on medications.
- Important reasons for not starting medications:
- If medications are started:
- The doctor will follow the drug levels, which require frequent blood tests, and will watch closely for side effects. Often, it takes weeks to months to adjust the medications, and sometimes more than one, or a different, medicine is needed.
- If your child has continuous seizures (status epilepticus), they will be treated very aggressively with IV antiseizure medications, admitted to the intensive care unit, and possibly be placed on a breathing machine.
There are medicines and treatments referred to as “rescue medications,” which can and should be used in specific situations. They do not take the place of daily medications and should only be used to help stop a seizure quickly in emergency situations. Depending on the circumstance, they can be administered:
- Nasally - Sprayed up the nose
- Orally - Swallowed in pill form
- Sublingually - Placed under the tongue to dissolve
- Buccally - Placed between the cheek and the gum to dissolve
- Rectally - Given via a gel through the anus
The most commonly used medications are benzodiazepines because they get into the bloodstream quickly to start working on the brain to stop the seizure. They include: