What to do during active seizure in children?

Witnessing a child seizure is distressing for any parents, esp if they are witnessing first generalised seizure. Child with recurrent febrile seizure, children with epilepsy can have breakthrough seizure.

Follow the stepwise tips given below during active seizure in children. Approach the child without panic.

1. If you witness your child’s seizure, it is important to prevent the child from harming him or herself. Move the child away from potential hazards, such as a furniture, stairs, or traffic. Make the child lie down in floor or bed if sitting or standing.
2. Place the child to left lateral position to keep the throat clear and allow secretions (saliva or vomit) to drain and prevent aspiration of saliva or vomitus.
3. Do not try to stop or restrain the child’s movements or seizure. Do not put anything (pen, key, finger) in the child’s mouth, and do not try to hold the tongue. It is not possible to swallow the tongue, although some children may bite their tongue during a seizure, which can cause bleeding. If this happens, it usually does not cause serious harm.
4. Keep an eye on a clock or watch. Seizures that last for more than five minutes require immediate treatment and may need hospitalization.
5. Use intranasal midazolam during active seizure, as prescribed by the pediatric neurologist if seizure lasts more than a minute.
6. Stay with the child until the seizure ends. Allow the child to sleep after the seizure if he/she is tired.
7. Do not try to give food, liquid, or medicines 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.
8. Discuss a post-seizure plan of care with your pediatric neurologist.