What a carer does during a convulsion
The mhGAP-IG teaches carers of people with epilepsy a few simple, safe steps. During a convulsion, lay the person down on her side with the head turned to help breathing, put nothing in her mouth, do not restrain her, and stay with her until the convulsion stops and she wakes up. Turning her on her side lets saliva and vomit drain out of the mouth and keeps the tongue from falling back, which protects the airway. Staying until she is awake allows the carer to watch her breathing and recognize when help is needed.
Other safe actions
The carer can move hard or sharp objects away, cushion her head with something soft, loosen tight clothing around the neck, and note the time the convulsion started. After the jerking stops, the person is often drowsy and confused for a while, the postictal phase; she should be allowed to rest on her side and should not be given food, drink, or tablets until she is fully awake and able to swallow.
| Instruction | Safe? | Reason |
|---|
| Turn her on her side and stay until she wakes | Yes | Protects the airway; allows monitoring |
| Put a spoon between her teeth | No | Can break teeth or block the airway |
| Give water and her tablet when jerking stops | No | Choking risk while drowsy |
| Hold her arms and legs firmly | No | Does not stop the seizure; can cause injury |
Why the other instructions are unsafe
Putting a spoon or any object between her teeth is a dangerous myth; it can break teeth, injure the mouth, or block the airway, and people cannot swallow their tongue. Giving water or tablets as soon as the jerking stops risks aspiration because she is still drowsy and may not swallow safely. Holding the arms and legs firmly does not shorten the seizure and can cause fractures, dislocations, or injury to the carer.
Watch out! Teach the warning signs that need care at a health facility: a convulsion lasting longer than 5 minutes, difficulty breathing, failure to wake up after the convulsion, repeated seizures without recovery in between, or injury during the seizure.
Exam takeaway
Key point! Seizure first aid: side-lying, nothing in the mouth, no restraint, stay until awake, and seek care if the convulsion lasts more than 5 minutes or she does not wake. These are the points mhGAP-IG asks health workers to teach families.