Epilepsy – first aid and safety

Epilepsy and safety risks

Epilepsy is a common condition of the brain where a person has a tendency to have recurrent unprovoked seizures.

About 2 in 3 people with epilepsy gain control of their seizures with medication, whilst 1 in 3 continue to have seizures.

When seizures are not well controlled, people with epilepsy face a higher risk of injury from seizures, including falls, burns, drowning, accidents and sudden unexpected death. Gaining good seizure control is the most important step in reducing these risks.

Different types of seizures carry different risks, and lifestyle can also influence risk. For instance, poorly controlled tonic-clonic seizures pose the highest safety risk, and if you take part in activities such as mountain climbing, this risk is increased.

Life is never risk-free, but thinking about risks specific to you and discussing seizure management with your doctor are a good start to reducing some of your risks.

Seizure first aid

If you are with someone having a tonic-clonic seizure (where the body stiffens, followed by rhythmic muscle jerking), try to:

• stay calm and remain with the person
• keep them safe and protect them from injury
• place something soft under their head and loosen any tight clothing
• after the seizure is over, roll them on their side (if they have food or fluid in their mouth, roll them onto their side immediately)
• monitor their breathing
• reassure the person until they recover
• time the seizure, if you can.

Do not put anything into their mouth.

Do not restrain or move the person, unless they are in danger.

Epilepsy Smart Australia have produced a Seizure first aid information sheet showing what to do if someone has a seizure.

If a person having a seizure is in a wheelchair

If a person has a seizure when they are in a wheelchair, car seat or stroller:

• leave the person seated with the seatbelt on (unless it is causing injury)
• put the wheelchair brakes on
• if it’s a tilt wheelchair, tilt the seat and lock in position
• support their head until the seizure has ended
• lean the person slightly to one side to aid drainage of any fluid in the mouth.

After the seizure, if the person is having trouble breathing or they need to sleep, take them out of the chair and put them in the recovery position.

If their breathing difficulties continue, call an ambulance and closely monitor the person. Be prepared to perform CPR if they stop breathing.

Be aware that the CPR technique for adults is different to the CPR technique for young children and infants.

Seizures in water

If a seizure occurs in water:

• support the person's head so their face is out of the water
• tilt their head back to ensure a clear airway
• if the person is in a pool, remove them from the water when the jerking stops. Note: In the rare circumstance the jerking does not stop, seek help from others if possible, and remove the person from the water
• if the person is in the surf, remove them from the water immediately
• flotation devices may be useful when removing someone from water
• seek help if possible.

Once out of the water:

• call Triple Zero (000) for an ambulance immediately (Do this even if the person is breathing, as they may have inhaled water)
• place the person on their side
• check to see if they are breathing and monitor
• if they are not breathing, reposition the person onto their back and begin the appropriate form of CPR: CPR for adults is different to the CPR for young children and infants.

When to call an ambulance

Call Triple Zero (000) for an ambulance if:

• the seizure lasts for 5 or more minutes, or longer than what is usual for the person
• a second seizure quickly follows
• the person is not responding for more than 5 minutes after the seizure ends
• the person has breathing difficulties after the seizure stops
• it is the person's first known seizure
• the seizure occurs in water
• the person is injured
• you are in doubt.

For more information, watch the following animations from Epilepsy Action Australia:

• Seizure First Aid Animation for Children
• Seizure First Aid Animation for Adults

Epilepsy and your safety

Anything that affects a person’s conscious state, awareness or judgement can increase the risk of accidents.

If you have a seizure, your doctor will provide guidance about driving, using dangerous machinery, working at heights and general safety issues.

Some people choose to wear a medical alert bracelet or pendant with their epilepsy information, in case of an accident. Another option is to carry medical information in your wallet.

Epilepsy and driving

Seizures can affect your ability to drive safely.

If you have a seizure or are diagnosed with epilepsy, your doctor will inform you that you cannot drive. How long this period will last will depend on many things, including:

• what caused the seizure
• what type of seizure you had
• if it is epilepsy, and if so, what type of epilepsy.

If you meet fitness to drive criteria later on, you will be able to drive again – safely and legally. If you do not meet those criteria, your licence may not be renewed, or you may be issued a conditional licence.

It’s your responsibility to inform the driving authorities about having epilepsy or a seizure. In Victoria, this means informing Transport Victoria.

Driving against medical advice is illegal and dangerous to you, your passengers and the general public. There are many safety factors to consider as seizures often occur without warning.

If you continue to drive and are involved in a motor vehicle accident during the recommended non-driving period, and it’s found that a seizure was a contributing factor, you may be prosecuted and charged or even jailed.

Learn more about seizures and driving in Victoria.

Epilepsy and water safety

If a seizure happens in water, it can lead to a life-threatening situation. It’s important to think about water safety, recognise risks and what steps to take if a seizure may happen in the water.

Some simple suggestions include:

• Never swim alone.
• Wear an approved life jacket for water activities, including boating and fishing.
• Avoid water sports such as scuba and high board diving.
• Use an outside lane if swimming laps.
• Avoid swimming when tired or unwell.
• Don’t rest at the water’s edge.
• Have a shower rather than a bath, as showers pose less risk. If you only have a bath, use a hand-held shower attachment.
• Do not shower or bathe while alone in the house, if possible.
• Shower at a time when seizures are less likely to happen.
• Preferably have outward opening doors, sliding doors, half doors or doors that are easily removable fitted to the bathrooms.
• Keep bathroom doors unlocked.

Epilepsy and general hazards

People with seizures may face different risks but they can still enjoy everyday activities by being aware of potential hazards and taking simple safety steps. For example:

• Many injuries happen at home, so small changes can make a big difference, such as padding sharp corners, using non‑slip surfaces, adding barriers around heaters, and ensuring bathroom doors open both ways.
• Extra care may be needed if someone becomes confused or wanders during or after a seizure. This can include securing access to heights, water, and stairs, keeping doors closed when alone, ensuring someone has a spare key, and consider wearing medical ID.
• If falls are common, “fall‑proofing” the home can help; using carpets, avoiding glass furniture, and covering sharp edges. Some people may also benefit from a protective helmet.

Safety measures should be practical and balanced, supporting independence and enjoyment of daily life. Reviewing home, work and recreational environments can help identify and reduce risks.

Epilepsy Action Australia’s safety checklist offers further practical tips.

Seizure emergencies

Most seizures last less than 2 minutes and stop on their own. However, there are a small group of people with epilepsy who have severe or life-threatening seizures. For these people, seizures may be prolonged or happen in clusters.

These situations are considered seizure emergencies. They can lead to brain injury and can become life threatening, so it’s important to recognise and treat these seizures quickly.

Fortunately, it’s possible to administer medication in the community, in a way that is likely to stop a severe seizure. This medication can be prescribed by the treating specialist in the event of a seizure emergency.

Sudden unexpected death in epilepsy (SUDEP)

Sudden Unexpected Death in Epilepsy (SUDEP) is when a person with epilepsy dies suddenly and prematurely and no reason for death is found.

SUDEP deaths are often unwitnessed, with many occurring overnight. There may be obvious signs a seizure has happened, though this isn’t always the case.

The cause of SUDEP is not yet known. Researchers are investigating a range of possibilities such as the effect of seizures on breathing and the heart.

SUDEP occurs in approximately 1 in 1000 people with epilepsy.

Having active or poorly controlled seizures increases risk of injury and death. Research has shown that there are certain types of seizure that increase SUDEP risk. Ask your doctor for more information about SUDEP or get a SUDEP and Safety Checklist done by your GP or an epilepsy nurse.

Reducing the risks of SUDEP

Knowing about epilepsy-related risks of injury and death means you can act to reduce them. Steps you can take to reduce seizure-related risks, injury or death are:

• Get the best seizure control possible
  • take your medication as prescribed
  • speak to your doctor if you’re not happy with your current medication or side effects
  • have regular reviews with your doctor.
• Be involved in managing your seizures
  • avoid any known seizure triggers for you
  • avoid drinking too much alcohol
  • know when your seizures are most likely to occur
  • get enough sleep
  • be healthy
  • manage stress.
• Make sure those close to you know what to do in case of a seizure.

For more information, see Seizures and risk.

Where to get help

• Your GP (doctor)
• Neurologist
• Epilepsy Action Australia Tel. 1300 37 45 37
• Epilepsy Action Australia's animated seizure first-aid videos aimed at both adults and children.
• The National Epilepsy Support Service (NESS) Tel. 1300 761 487 or email support@epilepsysmart.org.au – provides support and information
• Epilepsy Foundation Victoria Information Line Tel. 1300 761 487