Essentials of Epilepsy first-aid – Epilepsy learner Video 6

A seizure episode can catch a parent off guard. This makes it imperative to arm oneself with the correct information to help tackle the situation swiftly and carefully. Knowing how to distinguish a seizure episode from a seizure emergency can be very challenging to the care givers under the circumstances.

This article is based on a video from Nayi Disha’s ‘‘Parent education series’  on Epilepsy and seizure management. In this video Dr. Nikit Milind Shah talks about the essentials of first-aid in epilepsy management.

First aid for seizure management

Here are some do’s and don’ts when your child has a seizure

DO’s

1. Stay calm and composed to provide effective help. 
2. Note the start and end time of the seizure to track its duration.
3. Gently roll the child onto their side (recovery position).
4. Clear the area of harmful objects like sharp furniture or dangerous items.
5. Place something soft (e.g., cushion) under their head to prevent injury.
6. Wipe away secretions from the nose or mouth to keep the airway clear.

DONT’S 

• Do not panic — staying calm helps you act effectively. Do not restrain your child’s movements.
• Do not forcibly open your child’s mouth, especially with your fingers.
• Do not put anything in your child’s mouth (food, water, or objects).
• Do not try to call your doctor during the seizure — if needed, go directly to the nearest emergency clinic.

For quick guidance, an infographic on the do’s and don’ts of seizure first aid is available for download on the Nayi Disha website.

Guidelines for administering nasal midazolam spray – rescue treatment 

Nasal midazolam spray can be used as a rescue treatment for seizures lasting longer than 5 minutes. 

This spray does not replace the child’s daily oral anti‑seizure medications prescribed 

Steps to administer

1. Clean the child’s nose gently.
2. Hold the medication properly in your hand.
3. Lift your child’s head slightly upright.
4. Prime the spray by pressing 1–2 times into the air.
5. Administer the spray into the nostril, following the exact dose advised by the doctor.

When to seek emergency care

Parents may need to take their child to the doctor under the following circumstances:

1. If it’s your child’s very first seizure
2. The seizure duration is more than five minutes
3. Child is experiencing breathing difficulty
4. The child appears blue around the lips
5. You are unsure that the child is recovering well after a seizure
6. The seizure is not controlled after the medication dose, there are chances that it could be a prolonged seizure or status epilepticus.

In these situations, rush your child to the nearest medical facility immediately. Even if it’s not the most specialized hospital, any clinic that can administer injectable anti‑epileptic medication is critical to prevent complications.

This article highlights essential guidance for caregivers on seizure first aid, offering clear do’s and don’ts to ensure safety during an episode. 

It explains practical steps to manage seizures calmly and effectively, provides instructions on the correct use of nasal midazolam spray as a rescue treatment, and outlines critical situations when emergency medical care is required.

Watch this video to understand
– How to provide appropriate seizure first-aid?
– When to rush your child to the nearest medical emergency?
– How to administer the Midazolam emergency nasal spray?

DISCLAIMER: Please note that this guide is for information purposes only. Please consult a qualified health practitioner for safe management.

Download this free infographic about Epilepsy first-aid management.

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